Assignment Summary of in utero conditions

The main aim of the report is to test the main in utero conditions that are involved in affecting the long-term development process of a baby that occurs through the use of the influenza pandemic in Taiwan. This is one of the best papers for medical researchers. The main reason is that the authors have selected and addressed the most important health problem with the help of data sets. There are two main authors of the whole paper. The main theme of the paper is related to the medical. This paper is related to the in-utero exposure to illness matter and also about the natural experiment occurred related to the influenza epidemic in Taiwan. Moreover, this paper will also combine different historical and current database. The database can be used for finding the results related to pandemic. This paper is also highlighting the other health problems that are related to kidney disease and respiratory system problems in the old age. This paper is written in an effective manner for the ease of the reader. All the information is mentioned in a proper way for future researchers. The starting abstract is highlighting all the important parameters of the paper.

1.      Importance of the paper of in utero conditions

The refer report is important in years to come. As the study focuses on the hypothesis of the fatal origin, which states that any chronic condition is traced back to their poor fatal growth. This refer report also can help in medical sciences as the chronic conditions can be traced back to their origin, and maybe it can help in the treatment as well. Author can also equip us to deal with any unforeseen epidemic in the near or distant future as well because maybe we can help pregnant women deal with the epidemic in a better way, we can educate them, and hence maybe we can save lives along the way. This is very important as there are many countries now in Africa where epidemics keep on occurring, and maybe we can better equip people to deal with as well.

Part 1

2.      Problems with the paper that currently make it unpublishable.

·         One of the problems I find is the choice of case study as the authors have chosen a very old pandemic to establish their case. The correctness of datasets can be questioned as it’s a very old dataset, maybe it would have been much better if they could choose a dataset from recent or not so distant past where they can find larger and more accurate datasets.

·         In this research work, the standard deviation is calculated for all male and female students. Standard deviation is a statistical technique to measure variance among selected variables. Researchers also added value in their research work by studying demographic variables as well rather than only making overall generalization for the whole population without considering the difference between various age groups and gender. Investigation of demographic variables makes this research study more detailed and specific for generalization of outcomes. 

·         However, researchers also paid enough attention to bias-related issues and research error control strategies. The presence of errors can reduce the effectiveness of research results. While bias is also undesirable in the research studies to ensure the accuracy of research results and findings. In this research study, researchers used instrumental variables as well as twin’s data to solve problems related to potential indigeneity. This problem was caused by omitted bias in the research work. Thus, conclusively research findings are adequate as well as valid. 

·         Another concern I find with the study is that the authors have not made any comparative studies, and maybe it was not possible as there might not be much wide class difference between the different classes in Taiwan. As it can also be a variable in regression and we can see if poor people had severe in utero effects in comparison to rich people, or people living in slums had more effects than people living in the house. According to my thinking, this can also affect this. Also, as authors highlighted that the in utero exposure to influenza caused people to have shorter heights. But this can be due to a number of other factors, like what were the heights of their parents, as there can be some correlation with height and contracting influenza.  Maybe the authors could have incorporated these variables as well into their methodology.

Part 2:

4. Problems with the paper that do not render the paper unpublishable

·         I find the methodology used in the study of the appropriate as the authors have taken into account various factors or variables to come to their conclusion. But I think that “mother mortality rate (MMR)” may be a very measure for the effect of exposure to influenza. As there are many other factors that will affect the MMR, and they should also be taken into account.

·         The living condition of the parents can also severely affect the MMR as I think if we were to check the correlation of MMR with the living condition of the parent in a region which is not having an epidemic, we would find out that poor living condition affects the mother mortality rate. Hence, if they want to keep on using MMR as the measure for the degree of exposure, they should remove the bias created by living conditions and other factors as well, so that we can have a better model which describes the correlation between in uterus exposure and chronic conditions in the long term.

·         Research study projects that researchers have applied proper statistical analysis techniques. The data set of the period 1912 to 1915 is collected and elaborate on higher morality tolls and other influenza waves. Without obtaining original data, researchers cannot study selected variables adequately.

·         Researcher also studied other health diseases related variables (e.g., cholera and malaria death tolls), which could have an indirect impact on the increase of maternal mortality rate (MMR). In accordance with my knowledge, while investigating cause and effect relationships or reasons for a situation, we must have to consider some indirect possible variables as sometimes effect can be caused by a different variable than what was studied. For instance, in this case, it seems that maternal mortality rate was increased in selected time-period because of the influenza epidemic; however, their health surveys also recorded an increase in deaths caused by cholera and malaria death tolls. Researchers also studied these variables to reach a reliable and valid research result.  

·         Moreover, the research article could be more appealing and informative if researchers had added tables for comparative analysis of demographic variables (e.g., age and gender) while presenting results of regression, correlation, and standard deviation. The addition of these tables could make it easy for readers to understand the actual results and outcomes of the research study.  

Further point of in utero conditions

The arguments about the critique of the refer report is maternal mortality rate is a best proxy available for measuring a severity of an effect of influenza on a fetus. This is showing a positive impact on the whole paper. Another thing is that the conclusion is written in a comprehensive way. This shows that if the reader is not satisfied with the abstract of the paper, then he can easily go for the conclusion section. This is because it contains all useful information related to the whole topic in a comprehensive way. Following the analysis and review of this research article, research work could be improved if researchers had added more detail about various formulas used in the data analysis part. The first of all formalized this conjecture through the proposing fetal origins hypothesis, which arguments is that inadequate in utero nutrition could program a fetus to prioritize brain growth at expense of other organs as well as tissues.