Multiple Traits in the Marriage Market: Does Diversity Sometimes Win?

A critical part of forming a long-term partnership, be it marriage, employment, co-authorship or some other commitment, is having to trade off among the various traits of one's potential partners. The nature of this trade-off depends both on the type of commitment being considered, as well as on the person making the commitment. In this paper I focus on the impact that this trade-off has on the marriage market equilibrium. Agents differ from one another along more than one trait, and preferences over traits is not homogenous. This implies that all agents do not agree completely on the desirability of potential partners. I characterize both the core allocation as well as the equilibrium that results when there are costly search frictions. The main finding is that in the presence of frictions, an individual who is moderately appealing to diverse tastes among the opposite sex may make a better match than someone who is found to be stunning by one group, but leaves the others cold. Assortative matching patterns emerge along more than one dimension, with the result that there is positive correlation along more than one trait in matched individuals.

Risk factors for meconium stained amniotic fluid and its implications

Background: Meconium staining of amniotic fluid (MSAF) has for long been considered to be a predictor of adverse fetal outcome and meconium aspiration syndrome (MAS), a major cause of perinatal morbidity and mortality. The aim of the study was to identify the risk factors, perinatal outcome in deliveries complicated by meconium stained amniotic fluid.Methods: This study is a prospective case control study of 100 patients done in a tertiary care hospital over a period of six months. Fifty patients with meconium stained amniotic fluid detected at any time during the course of labour or prior to it were enrolled in the study group. The inclusion criteria for the study were, a singleton pregnancy, cephalic presentation, term gestation and absence of major congenital anomalies. For the control group, the next woman giving birth following the index patient who satisfied the same set of inclusion criteria and had clear amniotic fluid was selected. Data was collected on a standardized pretested proforma.Results: Gestational age and parity showed no statistical significance between the study and control groups. Among antepartum and intrapartum risk factors, preeclampsia (32% in the study group vs 6% in the control group) p=0.0034, fetal growth restriction (12% vs 2%) p=0.05, fetal distress (36% vs 6%) p=0.0002 and labour dystocia (20% vs none in the control group) p=0.0009 were found to be statically significant. Caesarean section was considerably higher in patients with meconium stained amniotic fluid (66% vs 28%), p=0.0004. 3 (66%) patients had thin meconium and 17 patients (34%) had thick meconium stained amniotic fluid. Eighteen percent of the babies with meconium stained amniotic fluid had an Apgar of less than 7 at 5 minutes. Thirteen (26%) of the babies with meconium stained amniotic fluid developed MAS.Conclusions: Meconium stained amniotic fluid is associated with a higher incidence of operative deliveries resulting in an increased maternal morbidity. It is also associated with an increased neonatal morbidity due to birth asphyxia and respiratory depression at birth and a significant risk of neonatal mortality due to meconium aspiration syndrome

Awareness, attitude and practice of contraception among antenatal women in a tertiary care hospital- a cross sectional study

Background: Reproductive health services that empower women will greatly reduce the social and economic disruption in society. The aim of the study was to assess the level of awareness about different types of contraceptive choices and also to find out the current practice of contraceptive methods by antenatal women attending the antenatal outpatient department in a tertiary care hospital.Methods: This was a cross-sectional study conducted over a period of 6 months at SRM medical college hospital. 200 antenatal women attending outpatient department of obstetrics and gynecology were randomly selected and were interviewed with predesigned questionnaire. The data collected were analysed using percentage.Results: Majority of the women in the study were between 20 to 25 years. 97% were aware of contraception, 81% were aware of the needs of birth spacing and only 64% were aware of the benefits of birth spacing methods. About 74% of them were aware of more than one method of contraception. Condom (93%) was the most heard about method. Only 23% of these women gave a history of usage of contraception. Majority of these women had used condoms (16%). Sterilisation (44%) was considered the safest option among the contraceptive choices followed. Social circle (49%) and health care providers (42%) played a major role as source of knowledge. Majority of the antenatal women did not use contraception because of desire of child (41%) and fear of side effects (21%).Conclusions: The high contraceptive awareness and educational level did not reflect on the contraceptive usage level in this study. Hence proper counselling and education is required to motivate the women for contraceptive usage and eradication of myths involving the risks of using contraception

A Study on the Performances of Representation Strategies Handled For Text Categorization

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Analysis of adnexal masses requiring reoperation following hysterectomy

Background: Generally, we would like to preserve ovaries during hysterectomy for benign conditions. Many of them come back with ovarian cysts and pain abdomen. Recently there were ten cases of residual ovaries requiring surgery during a year period which made us analyze these cases.Methods: This retrospective descriptive analysis was conducted in SRM Medical College Hospital and Research Centre. Data about residual ovaries requiring surgery were retrieved from the medical records department and operation records and analyzed.Results: There were ten cases of residual ovaries from January 2015 to December 2015 requiring surgery. In 70% of patients, residual ovary syndrome occurred within 5 years of hysterectomy. Majority (80%) of them were following abdominal hysterectomy. The most common symptom among these patients was chronic pelvic pain. Pelvic adhesions were present in most of the cases. Follicular cyst and hemorrhagic corpus luteum were the commonest pathological findings in the residual ovaries (50%). There were two cases of endometriotic cyst and a case of secondary malignant ovarian tumor with primary growth from stomach in a 40 year old woman for whom hysterectomy was performed five years ago for adenomyosis.Conclusions: When the ovaries are preserved the woman should be properly counseled and should undergo periodic clinical and ultrasonographic follow-up

Sex‑specific differences in systemic immune responses in MIS‑C children

Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare manifestation of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) infection that can result in increased morbidity and mortality. Mounting evidence describes sex disparities in the clinical outcomes of coronavirus disease 2019 (COVID-19). However, there is a lack of information on sex-specific differences in immune responses in MIS-C. This study is an observational and cross-sectional study and we wanted to examine immune parameters such as cytokines, chemokines, acute phase proteins (APPs), growth factors, microbial translocation markers (MTMs), complement components and matrix metalloproteinases (MMPs) in MIS-C children, based on sex. Male children were associated with heightened levels of pro-inflammatory cytokines—IFNγ, IL-2, TNFα, IL-1α, IL-1β, IL-6, IL-12, G-CSF and GM-CSF, chemokines-CCL2, CCL11, CXCL1, CXCL8 and CXCL10, acute phase proteins-α-2M, CRP,growth factors VEGF and TGFα, microbial translocation markers- iFABP, LBP, EndoCAb, complement components—C1q, MBL and C3 and matrix metalloproteinases MMP-8 and MMP-9 compared to female children with MIS-C. These results indicate that the heightened immune response in males is a characteristic feature of MIS-C. These findings might explain the differential disease pathogenesis in males compared to females with MIS-C and facilitate a deeper understanding of this disease

Role of matrix metalloproteinases in multi-system inflammatory syndrome and acute COVID-19 in children

INTRODUCTION: Multisystem Inflammatory Syndrome in children (MIS-C) is a serious inflammatory sequela of SARS-CoV2 infection. The pathogenesis of MIS-C is vague and matrix metalloproteinases (MMPs) may have an important role. Matrix metalloproteinases (MMPs) are known drivers of lung pathology in many diseases. METHODS: To elucidate the role of MMPs in pathogenesis of pediatric COVID-19, we examined their plasma levels in MIS-C and acute COVID-19 children and compared them to convalescent COVID-19 and children with other common tropical diseases (with overlapping clinical manifestations). RESULTS: Children with MIS-C had elevated levels of MMPs (P < 0.005 statistically significant) in comparison to acute COVID-19, other tropical diseases (Dengue fever, typhoid fever, and scrub typhus fever) and convalescent COVID-19 children. PCA and ROC analysis (sensitivity 84–100% and specificity 80–100%) showed that MMP-8, 12, 13 could help distinguish MIS-C from acute COVID-19 and other tropical diseases with high sensitivity and specificity. Among MIS-C children, elevated levels of MMPs were seen in children requiring intensive care unit admission as compared to children not needing intensive care. Similar findings were noted when children with severe/moderate COVID-19 were compared to children with mild COVID-19. Finally, MMP levels exhibited significant correlation with laboratory parameters, including lymphocyte counts, CRP, D-dimer, Ferritin and Sodium levels. DISCUSSION: Our findings suggest that MMPs play a pivotal role in the pathogenesis of MIS-C and COVID-19 in children and may help distinguish MIS-C from other conditions with overlapping clinical presentation

Early Life Child Micronutrient Status, Maternal Reasoning, and a Nurturing Household Environment have Persistent Influences on Child Cognitive Development at Age 5 years : Results from MAL-ED

Funding Information: The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/Fogarty International Center. This work was also supported by the Fogarty International Center, National Institutes of Health (D43-TW009359 to ETR). Author disclosures: BJJM, SAR, LEC, LLP, JCS, BK, RR, RS, ES, LB, ZR, AM, RS, BN, SH, MR, RO, ETR, and LEM-K, no conflicts of interest. Supplemental Tables 1–5 and Supplemental Figures 1–3 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. Address correspondence to LEM-K (e-mail: [email protected]). Abbreviations used: HOME, Home Observation for Measurement of the Environment inventory; MAL-ED, The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project; TfR, transferrin receptor; WPPSI, Wechsler Preschool Primary Scales of Intelligence.Peer reviewe

Early life child micronutrient status, maternal reasoning, and a nurturing household environment have persistent influences on child cognitive development at age 5 years: Results from MAL-ED

Background: Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown. Objective: The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y. Methods: Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured and their relation with the Wechsler Preschool Primary Scales of Intelligence at 5 y was examined through use of linear regression. Results: Cognitive T-scores from 813 of 1198 (68%) children were examined and 5 variables had significant associations in multivariable models: mean child plasma transferrin receptor concentration (β: −1.81, 95% CI: −2.75, −0.86), number of years of maternal education (β: 0.27, 95% CI: 0.08, 0.45), maternal cognitive reasoning score (β: 0.09, 95% CI: 0.03, 0.15), household assets score (β: 0.64, 95% CI: 0.24, 1.04), and HOME child cleanliness factor (β: 0.60, 95% CI: 0.05, 1.15). In multivariable models, the mean rate of enteropathogen detections, burden of illness, and complementary food intakes between birth and 2 y were not significantly related to 5-y cognition. Conclusions: A nurturing home context in terms of a healthy/clean environment and household wealth, provision of adequate micronutrients, maternal education, and cognitive reasoning have a strong and persistent influence on child cognitive development. Efforts addressing aspects of poverty around micronutrient status, nurturing caregiving, and enabling home environments are likely to have lasting positive impacts on child cognitive development.publishedVersio

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population