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Background There is very little information on the beliefs and perceptions of mothers about SIDS and its related risk factors in Africa. To better understand parental decisions about infant sleep practices and other risk factors for SIDS, we conducted focus group discussions (FGDs) with mothers of infants in Lusaka, Zambia. Methods FGDs involved 35 purposively sampled mothers aged 18–49 years. FGDs were conducted using a semi-structured interview guide in the local language, Nyanja. These were translated, transcribed verbatim into English, and then coded and analyzed using thematic analysis in NVivo 12. Results Six FGDs were conducted with 35 mothers in April-May 2021 across two study sites. FGD Participants were generally aware of sudden unexplained infant deaths, with several describing stories of apparent SIDS in the community. The side sleeping position was preferred and perceived to be safer for the infant with most believing the supine position posed an aspiration or choking risk to the infant. Bedsharing was also preferred and perceived to be convenient for breastfeeding and monitoring of the infant. Experienced family members such as grandmothers and mothers-in-law, and health care workers were frequently cited as sources of information on infant sleep position. A heightened awareness of the infant’s sleeping environment was suggested as a mechanism to prevent SIDS and smothering. Conclusions Decisions about bedsharing and infant sleep position were guided by maternal beliefs and perceptions about what is convenient for breastfeeding and safer for the infant. These concerns are vital to designing tailored interventions to address sleep-related sudden infant losses in Zambia. Public health campaigns with tailored messages that address these concerns are likely to be effective at ensuring optimal uptake of safe sleep recommendations.

Background: The contribution of sudden unexpected infant death (SUID) has received little attention in global health. The objective of this study was to estimate the burden of SUID in Lusaka, Zambia. Methods: Verbal autopsies were conducted on infants who died in Lusaka, between 2017 and 2020.  From these, we performed a qualitative analysis of the free text narratives of the final series of events leading to each infant’s death and classified these as symptomatic deaths or SUID. Any narrative that described an infant who was otherwise healthy with no antecedent illness prior to death and found dead in bed after a sleep episode was classified as SUID. We used logistic regression to test for statistical differences between asymptomatic deaths and SUIDs on key infant, maternal and other risk factors of SUIDs. Results: Eight hundred and nine verbal autopsies were conducted with families of decedent infants younger than six months of age. A total of 92.6% (749/809) had presented with symptoms prior to death, whereas 7.4% (60/809) died without preceding symptoms or obvious cause of death. Of these, 16/60 were compatible with accidental suffocation deaths, and 54/60 appeared to be sudden infant death syndrome.  SUID deaths were concentrated in infants younger than two months of age with peak age of one to two months. Age at death was the only significant factor in multivariate analysis. Infants aged between one and two months had 2.84 increased odds of suspected SUIDs compared to infants in the first month of life (aOR = 2.84, 95% CI: 1.31, 6.16). Conclusions: Our findings suggest SUID could be accounting for a significant proportion of infant deaths in Zambia, but this cause of infant mortality is going unrecognized. Public health interventions in Zambia, and Africa more broadly, are likely overlooking SUIDs as an important cause of infant mortality.

While sudden infant death syndrome (SIDS) has long been recognized as a leading preventable cause of infant mortality in high-income countries, little is known about the burden of SIDS in Africa. To address this knowledge gap, we conducted the first systematic review of SIDS-related publications in Africa. Our objective was to assess the prevalence of SIDS and its risk factors in Africa. We systematically searched PubMed, Embase, Web of Science, Cochrane, and Google Scholar to identify studies published until December 26, 2020. Review authors screened titles and abstracts, and selected articles independently for full-text review. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS) or a modification. Data on the proportion of infants who died of SIDS and reported prevalence of any risk factors were extracted using customized data extraction forms in Covidence. Our analysis rested on 32 peer-reviewed articles. Nine studies presented prevalence estimates on bedsharing and prone sleeping, suggesting near-universal bedsharing of infants with parents (range, 60 to 91.8%) and frequent use of the prone sleeping position (range, 26.7 to 63.8%). Eleven studies reported on the prevalence of SIDS, suggesting high rates of SIDS in Africa. The prevalence of SIDS ranged from 3.7 per 1000 live births in South Africa, 2.5 per 1000 live births in Niger, and 0.2 per 1000 live births in Zimbabwe. SIDS and other sudden infant deaths accounted for between 2.5 to 21% of infant deaths in South Africa and 11.3% in Zambia. Africa may have the highest global rate of SIDS with a high burden of associated risk factors. However, majority of the studies were from South Africa which limits generalizability of our findings to the entire continent. There is an urgent need for higher quality studies outside of South Africa to fill this knowledge gap. Prospero Registration Number: CRD42021257261.

[Andrew Dreschel] comments on the impassioned speeches of federal Liberals, which seem ludicrous in view of their former stance on this issue. But why the ruckus? Have they become [George Bush] clones? Enlightened? Discovered a fervour for Canada's Charter of Rights and Freedoms?

I am angered by the June 30 letters regarding George Argyros and Donald Bren being photographed with presidential candidate Bob Dole.

Through drug exposure, a rare, transient transcriptional program characterized by high levels of expression of known resistance drivers can get ‘burned in’, leading to the selection of cells endowed with a transcriptional drug resistance and thus more chemoresistant cancers. Therapies that target signalling molecules that are mutated in cancers can often have substantial short-term effects, but the emergence of resistant cancer cells is a major barrier to full cures 1 , 2 . Resistance can result from secondary mutations 3 , 4 , but in other cases there is no clear genetic cause, raising the possibility of non-genetic rare cell variability 5 , 6 , 7 , 8 , 9 , 10 , 11 . Here we show that human melanoma cells can display profound transcriptional variability at the single-cell level that predicts which cells will ultimately resist drug treatment. This variability involves infrequent, semi-coordinated transcription of a number of resistance markers at high levels in a very small percentage of cells. The addition of drug then induces epigenetic reprogramming in these cells, converting the transient transcriptional state to a stably resistant state. This reprogramming begins with a loss of SOX10-mediated differentiation followed by activation of new signalling pathways, partially mediated by the activity of the transcription factors JUN and/or AP-1 and TEAD. Our work reveals the multistage nature of the acquisition of drug resistance and provides a framework for understanding resistance dynamics in single cells. We find that other cell types also exhibit sporadic expression of many of these same marker genes, suggesting the existence of a general program in which expression is displayed in rare subpopulations of cells.

The objective of this study was to compare the hydrological performance of an irrigated, 127 mm deep green roof, planted with vegetation native to the New York City area, to a conventional, non-irrigated, 100 mm deep green roof, planted with drought-tolerant Sedum spp. Four years of climate and runoff data from both green roofs were analyzed to determine seasonal stormwater retention. Empirical relationships between rainfall and runoff were developed for both roofs, and applied to historical rainfall data in order to compare stormwater retention values for different rainfall depths. Crop coefficients for the vegetation on each green roof were estimated using the soil moisture extraction function. This function was also used to estimate monthly evapotranspiration. Despite being irrigated, the green roof with native vegetation retained more stormwater per annum (64%) than the non-irrigated green roof planted with Sedum spp. (54%). The green roof planted with native vegetation also had approximately twice the crop coefficient (1.13) than the green roof planted with Sedum spp. (0.57), indicating that the New York City native plants transpire more stormwater than the Sedum spp. plants given certain climate and substrate moisture conditions. Overall, the results of the study indicate that, for the New York City climate region, irrigated green roofs of native vegetation have the capacity to better manage stormwater than non-irrigated green roofs planted with drought-tolerant succulents.

Scientific research-especially high-impact research-is increasingly being performed in teams that are interdisciplinary and demographically diverse. Nevertheless, very little research has investigated how the climate on these diverse science teams affects data sharing or the experiences of their members. To address these gaps, we conducted a quantitative study of 266 scientists from 105 NSF-funded interdisciplinary environmental science teams. We examined how team climate mediates the associations between team diversity and three outcomes: satisfaction with the team, satisfaction with authorship practices, and perceptions of the frequency of data sharing. Using path analyses, we found that individuals from underrepresented groups perceived team climate more negatively, which was associated with lower satisfaction with the team and more negative perceptions of authorship practices and data sharing on the team. However, individuals on teams with more demographic diversity reported a more positive climate than those on teams with less demographic diversity. These results highlight the importance of team climate, the value of diverse teams for team climate, and barriers to the full inclusion and support of individuals from underrepresented groups in interdisciplinary science teams.

Heart shape captures variation in cardiac structure beyond traditional phenotypes of mass and volume. Although observational studies have demonstrated associations with cardiometabolic risk factors and diseases, its genetic basis is less understood. We utilised cardiovascular magnetic resonance images from 45,683 UK Biobank participants to construct a heart shape atlas from bi-ventricular end-diastolic surface mesh models through principal component (PC) analysis. Genome-wide association studies were performed on the first 11 PCs that captured 83.6% of shape variance. We identified 43 significant loci, 14 were previously unreported for cardiac traits. Genetically predicted PCs were associated with cardiometabolic diseases. In particular two PCs (2 and 3) linked with more spherical ventricles being associated with increased risk of atrial fibrillation. Our study explores the genetic basis of multidimensional bi-ventricular heart shape using PCA, reporting new loci and biology, as well as polygenic risk scores for exploring genetic relationships of heart shape with cardiometabolic diseases. Heart shape is heritable and potentially linked to cardiometabolic conditions. Here the authors perform GWAS on principle components of ventricular shape to identify 43 unique loci, 14 of which are novel for cardiac traits.