bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of Postpartum Hemorrhage Admission Risk Factor Stratification in a Large Obstetrics Population
Authors: Ruppel Halley , Liu Vincent X. , Gupta Neeru R. , Soltesz Lauren , Escobar Gabriel J.
Published: May 2020

Objective This study aimed to evaluate the performance of the California Maternal Quality Care Collaborative (CMQCC) admission risk criteria for stratifying postpartum hemorrhage risk in a large obstetrics population.

Study Design Using detailed electronic health record data, we classified 261,964 delivery hospitalizations from Kaiser Permanente Northern California hospitals between 2010 and 2017 into high-, medium-, and low-risk groups based on CMQCC criteria. We used logistic regression to assess associations between CMQCC risk groups and postpartum hemorrhage using two different postpartum hemorrhage definitions, standard postpartum hemorrhage (blood loss ≥1,000 mL) and severe postpartum hemorrhage (based on transfusion, laboratory, and blood loss data). Among the low-risk group, we also evaluated associations between additional present-on-admission factors and severe postpartum hemorrhage.

Results Using the standard definition, postpartum hemorrhage occurred in approximately 5% of hospitalizations (n = 13,479), with a rate of 3.2, 10.5, and 10.2% in the low-, medium-, and high-risk groups. Severe postpartum hemorrhage occurred in 824 hospitalizations (0.3%), with a rate of 0.2, 0.5, and 1.3% in the low-, medium-, and high-risk groups. For either definition, the odds of postpartum hemorrhage were significantly higher in medium- and high-risk groups compared with the low-risk group. Over 40% of postpartum hemorrhages occurred in hospitalizations that were classified as low risk. Among the low-risk group, risk factors including hypertension and diabetes were associated with higher odds of severe postpartum hemorrhage.

Conclusion We found that the CMQCC admission risk assessment criteria stratified women by increasing rates of severe postpartum hemorrhage in our sample, which enables early preparation for many postpartum hemorrhages. However, the CMQCC risk factors missed a substantial proportion of postpartum hemorrhages. Efforts to improve postpartum hemorrhage risk assessment using present-on-admission risk factors should consider inclusion of other nonobstetrical factors.
Trends in the Treatment of Pectus Excavatum in the Netherlands
Authors: Zuidema Wietse P. , van der Steeg Alida F. W. , Oosterhuis Jan W. A. , van Heurn Ernest
Published: May 2020

Introduction Pectus excavatum (PE) is the most common deformity of the anterior chest wall and can be corrected surgically with different techniques. In the past years, medical literature suggests that the minimal invasive surgical correction of PE (MIRPE) has currently become the operation technique of choice in Europe, and the number of PE patients undergoing surgery has increased. The aim of this study was to evaluate trends in the number of patients operated on and the surgical techniques generally used in patients with PE in the Netherlands.

Materials and Methods From the registration by Statistics Netherlands, the numbers of live births and gender were obtained for the period 1980 to 2017. Furthermore, from the Dutch hospital registration performed by Kiwa Prismant systems, the number of total surgical procedures of PE patients from the period 1998 to 2017, and the numbers of open and MIRPE surgery were obtained over the period 2005 to 2013.

Results The birth rate in Netherlands has stayed more or less stable in the last two decades. The number of PE patients asking for correction, however, has increased. In addition, the percentage of thoracoscopic assisted correction has increased.

Conclusion The increase in correction of PE is not due to an increased incidence but to an increase of patient wishes. The use of MIRPE is gaining popularity over time.
Analysis of flow characteristics downstream delta-winglet vortex generator using stereoscopic particle image velocimetry for laminar, transitional, and turbulent channel flow regimes
Authors: Hamidouche S. , Simo Tala J. V. , Russeil S.
Published: May 2020

The evolution of flow structures downstream a single pair of delta-winglet vortex generators (VGs) is investigated experimentally using stereoscopic particle image velocimetry. In addition, the laser Doppler anemometer technique is performed to characterize the upstream flow. Experiments are conducted in a bounded channel flow (height H) for the Reynolds numbers (ReDH, based on the hydraulic diameter height) ranging from 400 to 12 000. The purpose of this study is to provide detail insight into the generation and the dissipation of longitudinal vortices over a wide flow regime range including the laminar–turbulent transition. With a focus on transverse sections, the flow field is detailed. For all flow regimes, the main flow topology shows that the two main counter-rotating vortices are generated at a certain streamwise distance downstream the VG and then are advected gradually toward the channel lateral-walls. A secondary vortex pair is induced closer to the wall. Our results show that close to the VGs, local regions (1 > z/H > −1) are strongly defined as the inception of the turbulence production. The intensity of this latter is shown to vanish beyond a certain distance far from the origin of the perturbation (when x/H is greater than 3). The instantaneous flow structure describes the mechanism of vortex generation, relying on the intermittence of the flow organization and the sweep and ejection event balance. Detailed analysis on the turbulence properties and wall shear stress has been assessed and revealed that the flow transition induced by the perturbation of the VG is achieved at a Reynolds number no greater than 1500.
Multiple particle tracking microrheological characterization:
Fundamentals, emerging techniques and applications
Authors: McGlynn John A. , Wu Nan , Schultz Kelly M.
Published: May 2020

Multiple particle tracking microrheology (MPT) is a passive microrheological technique that measures the Brownian motion of probe particles embedded in a sample to characterize material rheological properties. MPT is a powerful tool that quantifies material rheology in the low moduli range while requiring only small sample volumes and relatively simple data acquisition using video microscopy. MPT quantitatively characterizes spatiotemporal rheological properties and is particularly well suited for the investigation of evolving materials with complex microenvironments. MPT has expanded the study of a variety of materials including biofilms, colloidal gels, hydrogels, stimuli-responsive materials, and cell-laden biomaterials. The aim of this Tutorial is to summarize the fundamentals, illustrate the versatility, and highlight recent advances in MPT. In each application, we will highlight how MPT is uniquely positioned to gather rheological properties, which would be difficult, if not impossible, to attain with other rheological characterization techniques and highlight how MPT can be used to supplement other measurement techniques. This Tutorial should provide researchers with the fundamental basis and skills needed to use MPT and develop new MPT techniques to characterize materials for their unique applications.
Greatly enhanced magneto-optic detection of single nanomagnets using focused magnetoelastic excitation
Authors: Yang Wei-Gang , Schmidt Holger
Published: May 2020

Magnetization dynamics of nanomagnets directly determine the performance of magnetic storage and memory devices. Here, we report a 10-times enhancement of magnetization dynamics excitation of single nanomagnets using focused surface acoustic waves (SAWs), compared to conventional optical excitation. SAWs are generated via ultrafast optical excitation of an arc-shaped phononic grating and focused onto a single nanomagnet located at the focal spot of the grating. Thanks to the robust resonance excitation, we observe the strain-controlled ultrafast magnetization dynamics in a sub-100 nm single nanomagnet. This improved excitation efficiency was applied to exciting SAWs in four sets of gratings with different pitches using a single laser spot. This enabled selective excitation of any one of four identical nanomagnets at different frequencies simply by tuning an external magnetic field. This all-optical technique provides a method of addressing individual magnetic nano-oscillators and studying their intrinsic magnetization dynamics.
Dependence of nanoscale heat transfer across a closing gap on the substrate material and ambient humidity
Authors: Cheng Qilong , Sakhalkar Siddhesh , Ghafari Amin , Ma Yuan , Bogy David
Published: May 2020

We investigate the heat transfer across a closing nanoscale gap between an operational microelectronic device and a static substrate in ambient conditions. The device contains an embedded microheater and a nanoscale metal wire that works as a thermometer. The heater causes a microscale protrusion by thermal expansion such that its surface approaches the substrate until contact occurs. Meanwhile, the metal wire located near the center of the protrusion surface measures the temperature of the protrusion, which is dependent on the size of the gap, the substrate material, and the ambient conditions. We study the nanoscale heat transfer using three different substrates and find that their thermal conductivity plays an essential role. Finally, the experiments are conducted under different relative humidity (RH) conditions. The results show that the ambient humidity can also affect the nanoscale heat transfer when RH > 75%.
NAC transcription factor involves in regulating bacterial wilt resistance in potato
Authors: Chang Yannan , Yu Ruimin , Feng Jinlin , Chen Huize , Eri Hemu , Gao Gang
Published: May 2020

Bacterial wilt (BW) is a serious disease that affects potato (Solanum tuberosum L.) production. Although resistance to this disease has been reported, the underlying mechanism is unknown. In this study, we identified a NAC family transcription factor (StNACb4) from potato and characterised its structure, function, expression, its localisation at the tissue and its role in BW resistance. To this end, the transgenic Nicotiana benthamiana Domin lines were generated in which the expression of NACb4 was constitutively upregulated or suppressed using RNAi. Different tobacco mutants were stained after inoculating with Ralstonia solanacearum to observe the cell death and callose deposition. The results indicated that StNACb4 could be upregulated under the induction of R. solanacearum, and salicylic acid, abscisic acid and methyl jasmonate could also induce the expression of StNACb4. Tissue localisation analysis indicated that its expression was tissue specific, and it was mainly in the phloem of the vascular system of stems and leaves. NbNACb4 gene silencing can enhance the sensitivity of tobacco to R. solanacearum; on the contrary, StNACb4 gene overexpression can enhance the tolerance of tobacco to R. solanacearum. Meanwhile, StNACb4 gene overexpression can induce cell death and callose deposition in tobacco. The upregulated expression of StNACb4 can also activate the StPR10 gene expression. Our results provide important new insights into the regulatory mechanisms of bacterial wilt resistance in potato.
Potential water pollution from recycled concrete aggregate material
Authors: Purdy K. , Reynolds J. K. , Wright I. A.
Published: May 2020

Recycled concrete aggregates (RCA) are a widely used recycled building material. RCA materials have many uses such as a road base or backfilling trenches. Our study investigated the potential water-contamination risks of water exposed to RCA materials. We recirculated water for 60min through four different treatments. Two treatments were a PVC gutter filled with different size grades of RCA material (20mm and 45mm), the third treatment was a clean PVC gutter and the fourth and final treatment was an unused concrete water pipe. Results showed that RCA material exposed to water released a suite of contaminants that could be ecologically hazardous to aquatic species. RCA leached metals over the 60-min recirculation (aluminium, arsenic, barium, chromium, lead, manganese, molybdenum, titanium, lithium and strontium). Water exposed to RCA material exceeded aquatic ecosystem guidelines for aluminium by 50 times and lead by up to 12 times. RCA materials increased pH by up to 4.35 pH units and electrical conductivity (EC) by up to 11 times the starting EC (mean 27.9 µs cm–1). We suggest that RCA materials need to be used with caution in settings that could be exposed to water and flow to waterways of conservation value.
Tuning environmental timescales to evolve and maintain generalists
Authors: Sachdeva Vedant , Husain Kabir , Sheng Jiming , Wang Shenshen , Murugan Arvind
Published: May 2020

Significance

Generalists, or jacks-of-all-trades, that are fit across diverse environments can be difficult to evolve since they may not be as fit as a specialist in any particular environment. Such generalists are sought in immunology, where broadly neutralizing antibodies that can detect a broad variety of strains of a rapidly changing virus like HIV are often hard to evolve. Here, we find that generalists are most easily evolved in the most poorly understood regime of evolution—where the environment changes are neither fast nor slow but on the same timescale as evolutionary response of the population. Our methods let us propose temporal vaccination protocols, such as a chirp, that exploit this highly dynamic regime of evolution.
Atom-by-atom electrodeposition of single isolated cobalt oxide molecules and clusters for studying the oxygen evolution reaction
Authors: Jin Zhaoyu , Bard Allen J.
Published: May 2020

Significance

This study demonstrates how the controlled deposition of isolated single molecules of the heterogeneous oxygen evolution reaction electrocatalyst cobalt oxide on a carbon nanoelectrode can be carried out and characterized by electrochemical imaging to obtain size and relative catalytic activity compared to larger clusters of the same material. Previous results for Pt atoms on Bi or Pb substrates for the hydrogen evolution reaction showed that larger-size clusters display a higher kinetic rate. In contrast, results in this work with cobalt oxides on carbon show that a single molecule, Co
1
O
x
, is a better catalyst than larger clusters (
n
> 1).
Other people’s gaze encoded as implied motion in the human brain
Authors: Guterstam Arvid , Wilterson Andrew I. , Wachtell Davis , Graziano Michael S. A.
Published: May 2020

Keeping track of other people’s gaze is an essential task in social cognition and key for successfully reading other people’s intentions and beliefs (theory of mind). Recent behavioral evidence suggests that we construct an implicit model of other people’s gaze, which may incorporate physically incoherent attributes such as a construct of force-carrying beams that emanate from the eyes. Here, we used functional magnetic resonance imaging and multivoxel pattern analysis to test the prediction that the brain encodes gaze as implied motion streaming from an agent toward a gazed-upon object. We found that a classifier, trained to discriminate the direction of visual motion, significantly decoded the gaze direction in static images depicting a sighted face, but not a blindfolded one, from brain activity patterns in the human motion-sensitive middle temporal complex (MT+) and temporo-parietal junction (TPJ). Our results demonstrate a link between the visual motion system and social brain mechanisms, in which the TPJ, a key node in theory of mind, works in concert with MT+ to encode gaze as implied motion. This model may be a fundamental aspect of social cognition that allows us to efficiently connect agents with the objects of their attention. It is as if the brain draws a quick visual sketch with moving arrows to help keep track of who is attending to what. This implicit, fluid-flow model of other people’s gaze may help explain culturally universal myths about the mind as an energy-like, flowing essence.
Modulation of hippocampal brain networks produces changes in episodic simulation and divergent thinking
Authors: Thakral Preston P. , Madore Kevin P. , Kalinowski Sarah E. , Schacter Daniel L.
Published: May 2020

Significance

Studies have suggested a role for episodic memory in imagining future events and thinking creatively. Here, we tested the causal role played by episodic memory in future imagining and creative thinking by using fMRI-guided transcranial magnetic stimulation to disrupt neural activity in the hippocampus, a brain region involved in episodic memory. After transcranial magnetic stimulation, participants generated fewer episodic details when imagining future events and produced fewer creative ideas. fMRI analyses revealed that these behavioral reductions were linked to a reduction in hippocampal activity. Our findings have implications for brain targets and interventions to alleviate declines in memory, imagination, creativity, and other sorts of adaptive episodic functioning.
A methyl-TROSY approach for NMR studies of high-molecular-weight DNA with application to the nucleosome core particle
Authors: Abramov Gili , Velyvis Algirdas , Rennella Enrico , Wong Leo E. , Kay Lewis E.
Published: May 2020

Significance

Many of the important functions in the cell are performed by high-molecular-weight complexes that contain both protein and nucleic acid components. Although developments in solution NMR spectroscopy have facilitated the study of the protein portions of these complexes, similar quantitative studies of the nucleic acids have proven challenging. Here we describe an approach for labeling DNA molecules with methyl-group probes at specific sites, followed by the use of optimized NMR methods to obtain high-quality data in studies of these large molecular complexes. Studies of both the DNA and protein components of the nucleosome core particle are presented, including an investigation of how CpG methylation, an important epigenetic mark, affects the structural dynamics of the particle.
Connective frequencies in child-directed texts
Authors: Tellings Agnes E. J. M. , Penning de Vries Bart
Published: May 2020

Starting from a usage-based perspective of language acquisition, the present study investigates the occurrence of
connectives in BasiLex, an 11.5 million word corpus of texts Dutch children encounter during the primary school years (grades 1–6).
Specifically, we investigate how connective frequencies change across grades, how these changes reflect the theorized orders of connective
acquisition in the work of Bloom et al. (1980) and Evers-Vermeul & Sanders (2009), and we make a comparison with the frequencies of connectives in the adult written language
corpus Celex. Briefly summarized, our findings show that the numbers of connectives increase sharply after grade 1 and then more steadily
across grades 2 to 6; we see some reflection of the connective acquisition theory of Evers-Vermeul & Sanders in the connective
frequencies in texts offered to children; and we see some remarkable similarities between connective frequencies in the adult corpus Celex
as compared to connective frequencies in grade 1 and grade 6 texts in BasiLex. Our findings suggest that the written input offered to
children harmonizes with theoretical approaches that emphasize the incremental growth of word knowledge in children as a function of
exposure.
Electron channelling: challenges and opportunities for compositional analysis of nanowires by TEM
Authors: Ek M , Lehmann Sebastian , Wallenberg Reine
Published: May 2020

Energy dispersive x-ray spectroscopy in a transmission electron microscope is often the first method employed to characterize the composition of nanowires. Ideally, it should be accurate and sensitive down to fractions of an atomic percent, and quantification results are often reported as such. However, one can often get substantial errors in accuracy even though the precision is high: for nanowires it is common for the quantified V/III atomic ratios to differ noticeably from 1. Here we analyse the origin of this systematic error in accuracy for quantification of the composition of III–V nanowires. By varying the electron illumination direction, we find electron channelling to be the primary cause, being responsible for errors in quantified V/III atomic ratio of 50%. Knowing the source of the systematic errors is required for applying appropriate corrections. Lastly, we show how channelling effects can provide information on the crystallographic position of dopants.
Role of protic ionic liquid concentration in proton conducting polymer electrolytes for improved electrical and thermal properties
Authors: Nair Manjula G , Mohapatra Saumya R , Garda Marie-Rose , Patanair Bindu , Saiter-Fourcin Allisson , Thomas Sabu
Published: May 2020

Protic ionic liquids (PILs) in the acidic medium are known to show higher ionic conductivity than neat PIL or PIL in alkaline media. Hence, polymer electrolyte membranes (PEM) containing both PIL and acids are considered ideal for non-humidified intermediate temperature PEM fuel cells. Herein, we report non-aqueous proton conducting PEM made up of diethylmethylammonium trifluoromethanesulfonate; [dema][TfO] and neat phosphoric acid (H3PO4) with poly (vinylidene fluoride-co-hexafluoropropylene); PVDF-HFP as the host matrix. The presence of PIL significantly modified the structure and microstructure of the electrolyte films with the emergence of micropores in the PIL containing membranes. SEM images suggest leaching of PIL and phosphoric acid above 80 wt% of PIL in the electrolyte membranes. Thermogravimetric studies show that the dehydration in the PEM films due to phosphoric acid condensation at 100 °C–200 °C region is arrested by the presence of PIL. The maximum ionic conductivity at room temperature is ∼6.3 × 10−4S cm−1at 40 wt% of [dema][TfO] addition, which is two orders higher than that of the primary electrolyte (PE) containing only phosphoric acid in PVDF-HFP. This high conductivity in PEM films can be correlated to the increase in polarβandγphases as well as a drop in the total crystallinity fraction in the film. The study using dielectric spectroscopy reveals a strong coupling of ionic conductivity with the structural or segmental relaxation of the PVDF-HFP due to the presence of [dema][TfO] in the PEMs.
Network Structure of Physical, Cognitive, and Emotional Symptoms at Preseason Baseline in Student Athletes with Attention-Deficit/ Hyperactivity Disorder
Authors: Iverson Grant L , Jones Payton J , Karr Justin E , Maxwell Bruce , Zafonte Ross , Berkner Paul D , McNally Richard J
Published: May 2020

Objective

Preexisting attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for worse outcome following sport-related concussion. We used a statistical and psychometric approach known as network analysis to examine the architecture of physical, cognitive, and emotional symptoms at preseason baseline among student athletes with ADHD.

Method

A cohort of 44,527 adolescent student athletes completed baseline preseason testing with ImPACT® between 2009 and 2015. A subsample of athletes reporting a diagnosis of ADHD and at least one symptom were included in this study (N = 3,074; 14–18 years old, 32.7% girls). All participants completed the 22-item Post-Concussion Symptom Scale at preseason baseline.

Results

Student athletes reported high frequencies of difficulty concentrating (boys/girls = 50.7%/59.4%), emotional symptoms (nervousness: boys/girls = 30.2%/51.0%; irritability: boys/girls = 23.6%/34.8%; sadness: boys/girls = 21.4%/39.7%), sleep/arousal-related symptoms (trouble falling asleep: boys/girls = 39.5%/49.4%; sleeping less than usual: boys/girls = 36.2%/43.4%; and fatigue: boys/girls = 29.8%/36.4%), and headaches (boys/girls = 27.6%/39.0%) during preseason baseline testing. The most central symptoms included dizziness, which was related to multiple somatic symptoms, and increased emotionality, which was related to a cluster of emotional symptoms. Girls reported symptoms at a greater frequency than boys, and there was evidence for variance in the global strength of the symptom network across gender, but not specific intersymptom relationships.

Conclusion

In the absence of injury, symptoms that commonly occur after concussion interact and potentially reinforce each other among student athletes with ADHD at preseason. Symptoms common in ADHD (i.e., difficulty concentrating) are not necessarily the most central within the symptom network. These findings may inform more precise interventions for athletes with ADHD and prolonged recovery following concussion.
Ecological factors driving pollination success in an orchid that mimics a range of Fabaceae
Authors: Scaccabarozzi Daniela , Guzzetti Lorenzo , Phillips Ryan D , Milne Lynne , Tommasi Nicola , Cozzolino Salvatore , Dixon Kingsley W
Published: May 2020

Rewarding plants can enhance the pollination success of co-occurring plants pollinated by food mimicry. However, it is not always possible to readily discern between the effect of model and magnet species. Here, we tested for mimicry of co-occurring Fabaceae by the rewardless Diuris magnifica (Orchidaceae) and whether the number of flowers of Fabaceae, habitat remnant size and frequency of conspecifics, influenced the pollination success of D. magnifica. Trichocolletes bees were the primary pollinators of D. magnifica, on which they displayed similar behaviour as seen when feeding on Fabaceae. Quantification of spectral reflectance suggested that flowers of Bossiaea eriocarpa, Daviesia divaricata and Jacksonia sternbergiana may represent models for D. magnifica, whereas Hardenbergia comptoniana strongly differed in colour. Orchid pollination success was not directly affected by the number of model flowers, but the pollination rate was enhanced by increased numbers of Hardenbergia flowers. Pollination success of the orchid decreased with higher density of conspecifics, but did not exhibit a significant relationship with Trichocolletes occurrence, possibly because of the contribution of sub-optimal pollinator species. Fruit set of the orchid was greater in larger habitat remnants. Overall, pollination success of D. magnifica is affected by ecological factors related to the effectiveness of mimicry, numbers of co-flowering plants and anthropogenic landscape alteration.
Potential hazards of recent trends in liberal iron use for renal anemia
Authors: Nakanishi Takeshi , Kuragano Takahiro
Published: May 2020

A randomized controlled trial,the Proactive IV Iron Therapy in Haemodialysis Patients (PIVOTAL), has recently shown that a high-dose (‘proactive’) intravenous iron regimen was superior to a low-dose (‘reactive’) regimen for hemodialysis patient outcomes and overall safety. However, even in the low-dose group, a substantial amount of iron was administered to maintain serum ferritin >200 ng/mL. This type of comparison may have strongly affected the safety results. Iron has two opposite effects on erythropoiesis: it activates erythroid differentiation directly by supplying iron but inhibits it indirectly by stimulating hepcidin and enhancing oxidative stress. Hepcidin plays an essential role not only in iron homeostasis and the anemia of chronic kidney disease, but also in its complications such as atherosclerosis and infection. Its main stimulation by iron—and to a lesser degree by inflammation—should urge clinicians to avoid prescribing excessive amounts of iron. Furthermore, as serum ferritin is closely correlated with serum hepcidin and iron storage, it would seem preferable to rely mainly on serum ferritin to adjust iron administration, defining an upper limit for risk reduction. Based on our estimations, the optimal range of serum ferritin is ∼50–150 ng/mL, which is precisely within the boundaries of iron management in Japan. Considering the contrasting ranges of target ferritin levels between end-stage renal disease patients in Japan and the rest of the world, the optimal range proposed by us will probably be considered as unacceptable by nephrologists abroad. Only well-balanced, randomized controlled trials with both erythropoiesis-stimulating agents and iron will allow us to settle this controversy.
Lost in Transmission? John Berger and the Origins of Ways of Seeing (1972)
Authors: Conlin Jonathan
Published: May 2020

The documentary series Ways of Seeing was broadcast on BBC television in January 1972. Directed by Mike Dibb and presented by the marxist critic John Berger, the series addressed the canon of western art history as well as contemporary consumer culture. The conspicuous use of cross-cutting and music along with Berger’s emphatic ‘talking-head’ delivery were employed to dispel the aura enveloping ‘original’ artworks, and reveal the technologies by which art historians, curators and advertising agencies shored up a capitalist, western, male social order. The series and its associated book were canonical for the nascent disciplines of media and culture studies. Drawing on scripts and other materials from the BBC, Berger and Dibb archives, this essay explains how the four episodes were conceived and executed. It places the series in the context of Berger’s prior activity as artist, art critic, presenter and author, noting the influence of Frederick Antal, Walter Benjamin and others. It concludes that Berger’s charisma and the mastery of the relatively new technology of colour television displayed by the series undermined its intent: rather than encouraging viewers to use images in framing their own personal narratives, its message was consumed as an invitation to view all images in political terms.
Accounting for Wealth-Inequality Dynamics: Methods, Estimates, and Simulations for France
Authors: Garbinti Bertrand , Goupille-Lebret Jonathan , Piketty Thomas
Published: May 2020

Measuring and understanding the evolution of wealth inequality is a key challenge for researchers, policy makers, and the general public. This paper breaks new ground on this topic by presenting a new method to estimate and study wealth inequality. This method combines fiscal data with household surveys and national accounts in order to provide annual wealth distribution series, with detailed breakdowns by percentiles, age, and assets. Using the case of France as an illustration, we show that the resulting series can be used to better analyze the evolution and the determinants of wealth-inequality dynamics over the 1970–2014 period. We show that the decline in wealth inequality ends in the early 1980s, marking the beginning of a rise in the top 1% wealth share, though with significant fluctuations due largely to asset price movements. Rising inequality in savings rates coupled with highly stratified rates of returns has led to rising wealth concentration in spite of the opposing effect of house price increases. We develop a simple simulation model highlighting how changes in the combination of unequal savings rates, rates of return, and labor earnings that occurred in the early 1980s generated large multiplicative effects that led to radically different steady-state levels of wealth inequality. Taking advantage of the joint distribution of income and wealth, we show that top wealth holders are almost exclusively top capital earners, and increasingly fewer are made up of top labor earners; it has become increasingly difficult in recent decades to access top wealth groups with one's labor income only.
Are population-based models advantageous in estimating the lumen outputs from light-pollution sources?
Authors: Kocifaj M , Kómar L , Lamphar H , Wallner S
Published: May 2020

The total lumen output (TLO) from ground-based artificial light sources is required in a wide range of light-pollution models currently in use. No realistic assessment of diffuse light levels in the nocturnal environment is possible if the information on TLO is missing. Traditional approaches to skyglow modelling, if no lighting inventory is available, foresee to estimate TLO based on population and average amount of lumens per capita. However, we show in this letter that a model based on the area of artificially lit surfaces can reduce uncertainties in estimating TLO by 25 per cent for compact urban areas of defined centres and autonomous character and even 50 per cent for diffuse cities with small satellite towns interacting closely with the main city. The new model could be of great significance to the community of light-pollution researchers, especially astronomers, physicists, and modellers who use TLO routinely in light-pollution characterization.
European genetic ancestry associated with risk of childhood ependymoma
Authors: Zhang Chenan , Ostrom Quinn T , Hansen Helen M , Gonzalez-Maya Julio , Hu Donglei , Ziv Elad , Morimoto Libby , de Smith Adam J , Muskens Ivo S , Kline Cassie N , Vaksman Zalman , Hakonarson Hakon , Diskin Sharon J , Kruchko Carol , Barnholtz-Sloan Jill S , Ramaswamy Vijay , Ali-Osman Francis , Bondy Melissa L , Taylor Michael D , Metayer Catherine , Wiemels Joseph L , Walsh Kyle M
Published: May 2020

Background

Ependymoma is a histologically defined central nervous system tumor most commonly occurring in childhood. Population-level incidence differences by race/ethnicity are observed, with individuals of European ancestry at highest risk. We aimed to determine whether extent of European genetic ancestry is associated with ependymoma risk in US populations.

Methods

In a multi-ethnic study of Californian children (327 cases, 1970 controls), we estimated the proportions of European, African, and Native American ancestry among recently admixed Hispanic and African American subjects and estimated European admixture among non-Hispanic white subjects using genome-wide data. We tested whether genome-wide ancestry differences were associated with ependymoma risk and performed admixture mapping to identify associations with local ancestry. We also evaluated race/ethnicity-stratified ependymoma incidence data from the Central Brain Tumor Registry of the United States (CBTRUS).

Results

CBTRUS data revealed that African American and Native American children have 33% and 36%, respectively, reduced incidence of ependymoma compared with non-Hispanic whites. In genetic analyses, a 20% increase in European ancestry was associated with a 1.31-fold higher odds of ependymoma among self-reported Hispanics and African Americans (95% CI: 1.08–1.59, Pmeta = 6.7 × 10−3). Additionally, eastern European ancestral substructure was associated with increased ependymoma risk in non-Hispanic whites (P = 0.030) and in Hispanics (P = 0.043). Admixture mapping revealed a peak at 20p13 associated with increased local European ancestry, and targeted fine-mapping identified a lead variant at rs6039499 near RSPO4 (odds ratio = 1.99; 95% CI: 1.45–2.73; P = 2.2 × 10−5) but which was not validated in an independent set of posterior fossa type A patients.

Conclusions

Interethnic differences in ependymoma risk are recapitulated in the genomic ancestry of ependymoma patients, implicating regions to target in future association studies.
Self-reported alcohol consumption in doctors
Authors: Savage E , Sowole L , Shah S , Mirza Z , Cotzias C
Published: May 2020

Background

The UK government has prioritized reducing the harmful effects of excessive alcohol consumption on mental and physical well-being.

Aims

To assess self-reported alcohol consumption amongst doctors at an acute London Trust.

Methods

An opportunistic, anonymous, survey was conducted by Postgraduate Education Fellows over 2 weeks in December 2018. This included all grades of doctors from Foundation Year One to Consultant. The survey consisted of nine questions, modified from the alcohol use disorders identification test (AUDIT) and CAGE questionnaire.

Results

Of 446 doctors within our institution, 109 completed the survey (24%). Fourteen per cent of those surveyed abstained from alcohol, 21% drank monthly or less, 31% drank between two to four times per month, 25% drank two to three times per week and 9% drank greater than four times per week. In the preceding 2 years, 9% reported being unable to do what was expected of them on at least one occasion due to alcohol. Five per cent were concerned about alcohol affecting their performance. Two per cent were annoyed by criticism of their drinking, 9% felt guilty about drinking and 4% needed an eye-opener. Eighteen per cent wanted to reduce their alcohol consumption; however, 43% of the 109 doctors surveyed were uncertain where to seek help.

Conclusions

Twenty per cent of surveyed doctors reported consuming potentially hazardous levels of alcohol and 18% of respondents wanted to cut down. Forty-three per cent were unaware of sources of support. Our findings suggest a role for collaboration between Occupational Health departments and Postgraduate Education teams to support doctors misusing alcohol.
A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: a randomized controlled trial
Authors: Kempler Liora , Sharpe Louise A , Marshall Nathaniel S , Bartlett Delwyn J
Published: May 2020

Study Objectives

Poor sleep is commonly problematic during pregnancy and postpartum and is associated with depression. This trial investigated the efficacy of prenatal brief, group sleep psychoeducation in improving postpartum maternal sleep, and depression.

Methods

A total of 215 healthy expectant first-time mothers were cluster randomized (1:1) to receive either a 2 × 1.5 h psychoeducation intervention and a set of booklets, or a set of booklets only. Participants completed questionnaires during pregnancy (pre-intervention), and 6 weeks and 4 months postpartum. A post hoc subset of questionnaires was collected at 10 months postpartum. The primary hypothesis was the intervention group would have improved postpartum sleep quality, and reduced levels of insomnia symptoms, fatigue, and daytime sleepiness compared to the control group. Secondary outcomes included depression, anxiety, and stress.

Results

Linear mixed model analyses failed to confirm a group by time interaction on primary or secondary outcomes across all time points. There was no effect of the intervention on outcomes at 6 weeks, or 10 months postpartum. A significant time by group interaction was found at 4 months, favoring the intervention for sleep quality (p = 0.03) and insomnia symptoms (p = 0.03), but not fatigue or daytime sleepiness.

Conclusions

Prenatal sleep psychoeducation did not produce a sustained effect on maternal sleep throughout the postpartum period. There was little evidence of benefits on depressive symptoms.

Clinical Trial Registration

ACTRN12611000859987
The Continued Crisis of Maternal Mortality: Is Consolidation of Care the Answer?
Authors: Kacmar R.M. , Mhyre J.M.
Published: May 2020

(Anesth Analg. 2020;130:49–51)

There is a concerning trend of maternal mortality among nonwhite, impoverished, publicly insured women compared with white populations, and a patient’s care center could be a contributing factor to that mortality. Researchers have noted that high-risk medical centers who serve socially vulnerable populations tend to have poorer maternal outcomes, while white women frequently deliver in hospitals that have lower rates of severe maternal morbidity. Because of this imbalance, in-depth analysis is necessary to determine if higher morbidity rates can be attributed solely to the high-risk case rate in a certain area, or if some facilities provide a lower quality of care.
Sonographic Lower Uterine Segment Thickness After Prior Cesarean Section to Predict Uterine Rupture: A Systematic Review and Meta-analysis
Authors: Swift B.E. , Shah P.S. , Farine D.
Published: May 2020

(Anaesthesia. 2019;74:850–855)

The rate of trial of labor after cesarean (TOLAC) in the United States has markedly dropped over the past few decades. Uterine rupture is the most serious complication associated with TOLAC, with the risk ranging from 0.52% for women in spontaneous labor to 2.45% for women undergoing labor induction with prostaglandin. This risk may be contributing to the declining rate of TOLAC. Sonographic measurement of the lower uterine segment thickness has been evaluated by several prospective studies, but the cutoff values for recommending TOLAC in these studies have differed due to varying ultrasound methodologies. This study analyzed the ultrasound methodology used in each study and then conducted a meta-analysis of the predictive value of sonographic measurement of the lower uterine segment thickness for uterine rupture during labor.
Trial of Labor After Cesarean Section in Risk Pregnancies: A Population-based Cohort Study
Authors: Lehmann S. , Baghestan E. , Børdahl P.E. , Irgens L.M. , Rasmussen S.A.
Published: May 2020

(Acta Obstet Gynecol Scand. 2019;98:894–904)

Increased risk of adverse outcomes is higher in cases of unsuccessful trial of labor after cesarean (TOLAC) compared with a successful vaginal delivery or a planned repeat cesarean delivery. While identifying factors that could predict TOLAC failure is of clinical interest, there has been a lack of research on the risk of TOLAC failure in the setting of specific medical conditions other than diabetes and hypertensive disorders. This study aimed to investigate medical conditions as potential risk factors for TOLAC failure in Norway, which has a high TOLAC rate of ∼70%. TOLAC failure rates were also compared between women who did and did not undergo labor induction.
The Comparative Accuracy of a Handheld and Console Ultrasound Device for Neuraxial Depth and Landmark Assessment
Authors: Carvalho B. , Seligman K.M. , Weiniger C.F.
Published: May 2020

(Int J Obstet Anesth. 2019;39:68–73)

Historically, anesthesiologists have inserted neuraxial blocks for labor analgesia using surface landmarks as references to identify the interspaces and midline. There may be a number of advantages in using a neuraxial ultrasound device before the insertion procedure. Some benefits of ultrasound imaging include the ease of identifying the lumbar interspace level and ideal needle insertion site as well as the ability to estimate the depth to the epidural space. Previous studies have also reported that use of ultrasound resulted in fewer epidural failures, needle insertions, and needle redirections. While anesthesiologists have historically used laptop or console ultrasound machines to assist with neuraxial procedures, the portable handheld Accuro (AU; Rivanna Medical, Charlottesville, VA) device is a promising alternative for ultrasound imaging during lumbar epidural placements. It contains a proprietary algorithm that estimates the depth to the epidural space. The AU has not been compared with more complex ultrasound devices. This current study was conducted to compare the ultrasound-estimated depth to the epidural space as measured by the AU to depth measurements obtained with a console ultrasound (GU) device.
Do Epidural Catheter Size and Flow Rate Affect Bolus Injection Pressure in Different Programmed Intermittent Epidural Bolus Regimens? An In Vitro Study
Authors: Krawczyk P. , Piwowar P. , Sałapa K. , Lonc T. , Andres J.
Published: May 2020

(Anesth Analg. 2019;129:1587–1594)

Epidural analgesia is the most effective technique for labor analgesia, and programmed intermittent epidural bolus (PIEB) is a modality for delivering epidural analgesia that is becoming increasingly popular. However, the optimal settings for the PIEB technique have not been established. This study was undertaken to examine combinations of catheter types and pump characteristics and how they might influence epidural bolus injection pressure and the triggering of pump alarms. The investigators hypothesized that higher gauge catheters plus increased flow rates would increase the bolus injection pressure.
Neonatal Developmental and Behavioral Outcomes of Immediate Delivery Versus Expectant Monitoring in Mild Hypertensive Disorders of Pregnancy: 2-Year Outcomes of the HYPITAT-II Trial
Authors: Zwertbroek E.F. , Franssen M.T.M. , Broekhuijsen K. , Langenveld J. , Bremer H. , Ganzevoort W. , van Loon A.J. , van Pampus M.G. , Rijnders R.J.P. , Sikkema M.J. , Scherjon S.A. , Woiski M.D. , Mol B.W.J. , van Baar A.L. , Groen H.
Published: May 2020

(Am J Obstet Gynecol. 2019;221:154.e1–154.e11)

Immediate delivery is the preferred strategy for managing hypertensive disorders of pregnancy at term, which affects 10% of pregnancies worldwide. In pregnancies affected by hypertensive disorders before term, the adverse consequences of preterm birth for the neonate must be weighed against the benefits of immediate delivery for the mother. The Hypertension and Preeclampsia Intervention Trial at near Term (HYPITAT-II) studied this scenario and concluded immediate delivery was not justified in women with a mild hypertensive disorder diagnosed preterm. As preterm birth is associated with long-term neurodevelopmental problems, the aim of this study was to compare the offspring of mothers with late preterm hypertensive disorders at 2 years for neurodevelopmental and behavioral outcomes based on whether the mother was randomized to immediate delivery or expectant monitoring.
Delivery Outcome After Trial of Labor in Nulliparous Women 40 Years or Older: A Nationwide Population-based Study
Authors: Ankarcrona  , Altman D. , Wikström A. , Jacobsson B. , Wendel S.B.
Published: May 2020

(Acta Obstet Gynecol Scand. 2019; 98:1195–1203)

Over the last 3 decades, more and more women in high-income countries have postponed childbirth until the age of 40 or older. Women of advanced maternal age are more likely to undergo labor induction, which may be associated with risk of labor complications, such as intrapartum cesarean delivery and adverse neonatal outcomes. Therefore, obstetricians are unsure how to advise nulliparous women 40 years or older on labor and delivery method. These investigators conducted their study to compare delivery mode and risks of anal sphincter injury and 5-minute Apgar score <7 in older women (40 y or older) compared with women 25 to 29 years old for both labor induction and spontaneous onset of labor.
Resident Competency and Proficiency in Combined Spinal-Epidural Catheter Placement is Improved Using a Computer-Enhanced Visual Learning Program: A Randomized Controlled Trial
Authors: Nixon H.C. , Stariha J. , Farrer J. , Wong C.A. , Maisels M. , Toledo P.
Published: May 2020

(Anesth Analg. 2019;128:999–1004)

The apprenticeship model is still the most common method for residents to learn the technical skill of placing a spinal-epidural catheter. However, this method has its drawbacks, as on average it takes 45 to 60 attempts for a student to achieve a 90% success rate. While other methods have also been explored to teach this skill, such as watching videos of the procedure before attempting it, this study proposed that E-learning is a valid method to enhance anesthesiology education.
Efficacy of Intrathecal Fentanyl for Cesarean Delivery: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis
Authors: Uppal  , Retter S. , Casey M. , Sancheti S. , Matheson K. , McKeen D.M.
Published: May 2020

(Anesth Analg. 2020;130:111–125)

Cesarean delivery procedures have become more popular over the past few decades, and spinal anesthesia is a commonly used method of anesthesia for that operation. A majority of surveyed members of the Society for Obstetric Anesthesia and Perinatology stated that they preferred to administer hyperbaric 0.75% bupivacaine spinal anesthesia for cesarean deliveries, while a smaller percentage of anesthesiologists reported adding fentanyl, morphine, or a combination of both to an intrathecal bupivacaine solution. The addition of intrathecal opioids to spinal anesthesia medication has been reported to be effective for pain relief in some cases, but researchers are still unsure of the benefits, drawbacks, and optimal dosages of these medications. These investigators conducted their systematic review and meta-anlaysis to analyze the effectiveness of fentanyl both alone and in combination with morphine when added to intrathecal bupivacaine anesthesia during a cesarean delivery.