Predictive modeling for perinatal mortality in resource-limited settings

Importance: The overwhelming majority of fetal and neonatal deaths occur in low- and middle-income countries. Fetal and neonatal risk assessment tools may be useful to predict the risk of death.Objective: To develop risk prediction models for intrapartum stillbirth and neonatal death.Design, setting, and participants: This cohort study used data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women\u27s and Children\u27s Health Research population-based vital registry, including clinical sites in South Asia (India and Pakistan), Africa (Democratic Republic of Congo, Zambia, and Kenya), and Latin America (Guatemala). A total of 502 648 pregnancies were prospectively enrolled in the registry.Exposures: Risk factors were added sequentially into the data set in 4 scenarios: (1) prenatal, (2) predelivery, (3) delivery and day 1, and (4) postdelivery through day 2.Main outcomes and measures: Data sets were randomly divided into 10 groups of 3 analysis data sets including training (60%), test (20%), and validation (20%). Conventional and advanced machine learning modeling techniques were applied to assess predictive abilities using area under the curve (AUC) for intrapartum stillbirth and neonatal mortality.Results: All prenatal and predelivery models had predictive accuracy for both intrapartum stillbirth and neonatal mortality with AUC values 0.71 or less. Five of 6 models for neonatal mortality based on delivery/day 1 and postdelivery/day 2 had increased predictive accuracy with AUC values greater than 0.80. Birth weight was the most important predictor for neonatal death in both postdelivery scenarios with independent predictive ability with AUC values of 0.78 and 0.76, respectively. The addition of 4 other top predictors increased AUC to 0.83 and 0.87 for the postdelivery scenarios, respectively.Conclusions and relevance: Models based on prenatal or predelivery data had predictive accuracy for intrapartum stillbirths and neonatal mortality of AUC values 0.71 or less. Models that incorporated delivery data had good predictive accuracy for risk of neonatal mortality. Birth weight was the most important predictor for neonatal mortality

Top-Ranked Priority Research Questions for Soil Science in the 21st Century

Soils provide critical support essential for life on earth, regulate processes across diverse terrestrial and aquatic ecosystems, and interact with the atmosphere. However, soil science is constrained by a variety of challenges including decreasing funding prospects and a declining number of new students and young professionals. Hence, there is a crucial need to revitalize the impact, relevance, and recognition of soil science as well as promote collaboration beyond traditionally defined soil science research disciplines. Such revitalization and collaboration may be fostered by a shift from discipline-focused soil science research to cross-disciplinary research approaches and issue-driven research. In this paper, we present the outcomes of an initiative to identify priority research questions as a tool for guiding future soil science research. The collaborative approach involved four stages including (i) survey-based solicitation of questions; (ii) criteria-based screening of submitted candidate questions, (iii) criteria-based ranking of screened questions, and (iv) final revision of top ranked questions. The 25 top ranked research questions emerged from 140 submitted candidate questions within five predetermined thematic areas that represent current and emerging research areas. We expect that the identified questions will inspire both existing and prospective researchers, enhance multi-disciplinary collaboration both within and outside soil science, draw the attention of grant-awarding bodies, and guide soil science research to address pressing societal, agricultural, and environmental challenges. Furthermore, we hope that the approach and findings presented in this paper will advance soil sciences by fostering improved collaboration among soil science practitioners and researchers, as well as with other sciences, policy experts, and emerging professionals (including students) to meet societal needs

Gender-Based Screening for Chlamydial Infection and Divergent Infection Trends in Men and Women

Objectives: To assess the potential impact of chlamydial screening policy that recommends routine screening of women but not men. Methods: Population surveys of probability samples of Baltimore adults aged 18 to 35 years in 1997–1998 and 2006–2009 collected biospecimens to estimate trends in undiagnosed chlamydial infection. Survey estimates are compared to surveillance data on diagnosed chlamydial infections reported to the Health Department. Results: Prevalence of undiagnosed chlamydial infection among men increased from 1.6% to 4.0%, but it declined from 4.3% to 3.1% among women (p = 0.028 for test of interaction). The annual (average) number of diagnosed infections was substantially higher among women than men in both time periods and increased among both men and women. Undiagnosed infection prevalence was substantially higher among black than non-black adults (4.0% vs 1.2%, p = 0.042 in 1997–98 and 5.5% vs 0.7%, p,0.001 in 2006–09). Conclusion: Divergent trends in undiagnosed chlamydial infection by gender parallel divergent screening recommendations that encourage chlamydial testing for women but not for men

Fit for Life: Educating About a Healthy Lifestyle in Omaha Elementary Schools

Background: The prevalence of childhood obesity is increasing across the country. Health education at a young age is critical for children to establish healthy habits. The Fit for Life program is put together by Creighton medical students to inspire elementary students to lead a healthy lifestyle. The curriculum integrates physical exercise, real organ demonstrations, emotional wellness exercises, and nutritious meal building to model and encourage healthy habits. Methods: Over four weeks, medical students taught the 4th and 5th graders of two Omaha schools over live video while they followed along with hands-on activities. Before and after the program, students’ height and weight were measured to calculate BMI, and the students completed pre- and post-program quizzes. Paired t-tests were performed to analyze differences in student BMIs and quiz scores. Pre-program quiz scores of students who completed two consecutive years were compared using paired t-tests. Results: Student BMIs before and after the program showed no significant changes (p = 0.479, n = 45) however, quiz scores significantly improved after the program (p \u3c 0.001, n = 44). Self-reported survey responses after the program demonstrate increased motivation for a healthy lifestyle as well as improved understanding of the importance of sleep, exercise, reduced screen time, and healthy eating. Those who completed the program for two consecutive years had significantly higher pre-program quiz scores the second year (p \u3c 0.05, n = 18). Conclusion: Our study found a significant increase in pre- and post-program assessment scores which suggest improvement in student perspective and knowledge of healthy habits. Similarly, students who completed the program for two consecutive years demonstrated an increase in pre-program quiz scores suggesting retention of health knowledge. While there was no significant difference in pre- and post-program BMIs, results may be limited by the duration of the study, given that changes in weight are often insubstantial in the short-term.https://digitalcommons.unmc.edu/chri_forum/1006/thumbnail.jp

Chlamydia trachomatis Infection Among 15- to 35-Year Olds in Baltimore, MD

Chlamydia trachomatis (Ct) is the most frequently reported infectious disease in the U.S. This article reports population and subpopulation prevalence estimates of Ct and correlates of infection among 15-35 year-olds in Baltimore, MD, USA

An Open, Large-Scale, Collaborative Effort to Estimate the Reproducibility of Psychological Science

Reproducibility is a defining feature of science. However, because of strong incentives for innovation and weak incentives for confirmation, direct replication is rarely practiced or published. The Reproducibility Project is an open, large-scale, collaborative effort to systematically examine the rate and predictors of reproducibility in psychological science. So far, 72 volunteer researchers from 41 institutions have organized to openly and transparently replicate studies published in three prominent psychological journals in 2008. Multiple methods will be used to evaluate the findings, calculate an empirical rate of replication, and investigate factors that predict reproducibility. Whatever the result, a better understanding of reproducibility will ultimately improve confidence in scientific methodology and findings