Impact of inter-pregnancy interval on long-term endo-metabolic health of the offspring

Background: Inter-pregnancy interval (IPI), defined as the time interval between a live birth and estimated conception time of a subsequent pregnancy, has an established effect on perinatal outcome. The long-term impact of IPI on offspring is unknown. This study aimed to examine the effect of short and long IPIs on long-term endo-metabolic health of offspring.Subjects and Method: This population-based cohort study included singleton live births in parturient with at least one previous birth. Singleton deliveries between the years 1991-2014 in a regional tertiary medical center were included. Offspring were followed until 18 years of age for endo-metabolic related hospitalizations. Survival curves were used to compare cumulative incidence of endo-metabolic morbidity, and Cox proportional hazards models to control for confounders.Results: During the study period 144,397 deliveries met the inclusion criteria. Offspring following long IPIs exhibited higher rates of endo-metabolic related hospitalizations. Survival curve demonstrated a significantly higher cumulative incidence of endo-metabolic morbidity in the long IPI group (p<0.001). The Cox model demonstrated long IPI to significantly increase the risk for endo-metabolic related hospitalizations during childhood (aHR= 1.34, 95%CI= 1.06 to 1.70; p=0.015).Conclusion: Long IPI appears to have an independent impact on long-term endo-metabolic health of the offspring.Keywords: pregnancy interval, offspring, endocrine health, metabolic morbidity, obesityCorrespondence: Liron Seidman. The Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev. Ben-Gurion University Medical School, Soroka University Medical Center, 151 IzakRager Ave, Be’er-Sheva 84101, Israel. Email: [email protected]. Mobile: +972-524215808Journal of Maternal and Child Health (2020, 5(3): 321-330https://doi.org/10.26911/thejmch.2020.05.03.1

Metodología de decisiones robustas aplicada a sistemas agropecuarios: análisis de vulnerabilidades

El objetivo principal del artículo es realizar un análisis de las vulnerabilidades sobre el conjunto inicial de estrategias dentro de una metodología de Decisiones Robustas aplicada en un sistema de producción agrícola. El presente trabajo detalla este aspecto dentro del marco de un proyecto de investigación en el cual se desarrolla en profundidad la temática de las Decisiones Robustas aplicadas a la toma de decisiones de los productores agrícola. Un objetivo secundario es presentar la Metodología de las Decisiones Robustas en un ámbito educativo para que sus resultados puedan ser reproducidos en otros campos de aplicación.The main objective of the paper is to analyze the vulnerabilities of the initial set of strategies within a Robust Decisions methodology applicable in an agricultural production system. This study details the step of deeply analyzing vulnerabilities within a wider research project in which the Robust Decision Making methodology is analyzed for decision making in agriculture field. A secondary objective is to present the Robust Decision Making methodology from an educational point of view so that anyone will be able to reproduce the results in other field.Sociedad Argentina de Informática e Investigación Operativ

Metodología de decisiones robustas aplicada a sistemas agropecuarios: análisis de vulnerabilidades

El objetivo principal del artículo es realizar un análisis de las vulnerabilidades sobre el conjunto inicial de estrategias dentro de una metodología de Decisiones Robustas aplicada en un sistema de producción agrícola. El presente trabajo detalla este aspecto dentro del marco de un proyecto de investigación en el cual se desarrolla en profundidad la temática de las Decisiones Robustas aplicadas a la toma de decisiones de los productores agrícola. Un objetivo secundario es presentar la Metodología de las Decisiones Robustas en un ámbito educativo para que sus resultados puedan ser reproducidos en otros campos de aplicación.The main objective of the paper is to analyze the vulnerabilities of the initial set of strategies within a Robust Decisions methodology applicable in an agricultural production system. This study details the step of deeply analyzing vulnerabilities within a wider research project in which the Robust Decision Making methodology is analyzed for decision making in agriculture field. A secondary objective is to present the Robust Decision Making methodology from an educational point of view so that anyone will be able to reproduce the results in other field.Sociedad Argentina de Informática e Investigación Operativ

Metodología de decisiones robustas aplicada a sistemas agropecuarios: análisis de vulnerabilidades

El objetivo principal del artículo es realizar un análisis de las vulnerabilidades sobre el conjunto inicial de estrategias dentro de una metodología de Decisiones Robustas aplicada en un sistema de producción agrícola. El presente trabajo detalla este aspecto dentro del marco de un proyecto de investigación en el cual se desarrolla en profundidad la temática de las Decisiones Robustas aplicadas a la toma de decisiones de los productores agrícola. Un objetivo secundario es presentar la Metodología de las Decisiones Robustas en un ámbito educativo para que sus resultados puedan ser reproducidos en otros campos de aplicación.The main objective of the paper is to analyze the vulnerabilities of the initial set of strategies within a Robust Decisions methodology applicable in an agricultural production system. This study details the step of deeply analyzing vulnerabilities within a wider research project in which the Robust Decision Making methodology is analyzed for decision making in agriculture field. A secondary objective is to present the Robust Decision Making methodology from an educational point of view so that anyone will be able to reproduce the results in other field.Sociedad Argentina de Informática e Investigación Operativ

Death Of A Dream: The Variables Which Determine What Bargaining Agent Is Chosen At A Four-year College.

PhDEducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/187092/2/7215034.pd

Low Five-Minute Apgar Score and Neurological Morbidities: Does Prematurity Modify the Association?

(1) Background: We aimed to study whether a low 5 min Apgar score is associated with pediatric neurological morbidities throughout childhood. (2) Methods: A population-based retrospective cohort study was conducted. The exposed group was defined as offspring with a 5 min Apgar score &lt;7, and the remaining offspring served as the comparison group. The primary outcome was defined as pediatric hospitalizations with any neurological morbidity. Multivariable survival models were used to evaluate the association between the exposure and outcome while adjusting for potential confounders. Additional models were used to study this association separately among term- and preterm-born offspring. (3) Results: The study population included 349,385 singletons born between the years 1991 and 2021, 0.6% (n = 2030) of whom had a 5 min Apgar score &lt;7 (exposed). The cohort was followed for up to 18 years (median ~ 10.6). The incidence of neurological morbidity-related hospitalizations was higher among the exposed group versus the unexposed group (11.3% versus 7.5%, hazard ratio = 1.84; 95%CI 1.58&ndash;2.13). A low 5 min Apgar score remained a significant risk factor for neurological hospitalizations after adjusting for preterm delivery, maternal age, hypertension during pregnancy, gestational diabetes mellitus, chorioamnionitis, and delivery mode (adjusted hazard ratio = 1.61; 95%CI 1.39&ndash;1.87). However, after modeling term and preterm offspring separately, a low 5 min Apgar score was independently associated with neurological hospitalizations only among offspring born at term (adjusted hazard ratio = 1.16; 95%CI 0.87&ndash;1.55 and 1.70; 95%CI 1.42&ndash;2.02 for preterm and term offspring, respectively). (4) Conclusions: A low 5 min Apgar score is independently associated with childhood neurological morbidity, specifically among term-born offspring. Although not designed to identify risk for long-term health complications, Apgar scores may be a marker of risk for short- and long-term neurological morbidities among term newborns