bluuebunny/crossref_metadata_2025 huggingface dataset:
The added value of umbilical vein flow in predicting fetal macrosomia at 36 weeks of gestation: A prospective cohort study
Authors: Rizzo Giuseppe , Mappa Ilenia , Bitsadze Victoria , Khizroeva Jamilya , Makatsarya Alexander , D'Antonio Francesco
Published: November 2020

Introduction

Current models based on fetal biometry and maternal characteristics have a poor performance in predicting macrosomia. The primary aim of this study was to elucidate the diagnostic performance of fetal venous and arterial Dopplers in predicting macrosomia in the third trimester of pregnancy; the secondary aim was to build a multiparametric prediction model including pregnancy, ultrasound and Doppler characteristics able to predict macrosomia accurately.

Material and methods

Prospective cohort study including 2156 singleton pregnancies scheduled for routine ultrasound assessment at 36 weeks of gestation. Fetal biometry, estimated fetal weight (EFW), pulsatility index of the uterine, umbilical, and middle cerebral arteries, cerebroplacental ratio and umbilical vein blood flow (UVBF) normalized for fetal abdominal circumference (UVBF/AC) were recorded. Primary outcome was the prediction of fetal macrosomia, defined as a birthweight >90th percentile; secondary outcome was the prediction of newborns >4000 g. Logistic regression and area under the curve (AUC) analyses were used to analyze the data.

Results

Fetal macrosomia complicated 9.8% of pregnancies, and 7.7% of newborns had a birthweight >4000 g. At multivariate logistic regression analysis, maternal body mass index (adjusted odds ratio [aOR] 1.23), pregestational diabetes (aOR 1.83), a prior newborn with a birthweight >95th centile (aOR 1.49), EFW (aOR 2.23) and UVBF (aOR1.84) were independently associated with macrosomia, whereas gestational diabetes mellitus (P = .07) or any of the other Doppler parameters were not. EFW had an AUC of 0.750 and of 0.801 alone and in association with maternal characteristics for the prediction of macrosomia, respectively. The addition of UVBF to this model significantly improved the prediction of fetal macrosomia provided by maternal and ultrasound parameters with an AUC of 0.892 (De Long P = .044 and P = .0078, respectively). The predictive performance for birthweight >4000 g was similar and significantly improved when UVBF was included in the diagnostic algorithm.

Conclusions

Umbilical vein blood flow evaluation in the third trimester improves the diagnosis of fetal macrosomia. The optimal diagnostic performance for macrosomia is achieved by a multiparametric model including umbilical vein flow, maternal characteristics and EFW.
Why we succeed and fail in detecting fetal growth restriction: A population‐based study
Authors: Andreasen Lisbeth A. , Tabor Ann , Nørgaard Lone Nikoline , Taksøe‐Vester Caroline A. , Krebs Lone , Jørgensen Finn S. , Jepsen Ida E. , Sharif Heidi , Zingenberg Helle , Rosthøj Susanne , Sørensen Anne L. , Tolsgaard Martin Grønnebæk
Published: November 2020

Introduction

The objective of this study was to explore the association between detection of fetal growth restriction and maternal‐, healthcare provider‐ and organizational factors.

Material and methods

A historical, observational, multicentre study. All women who gave birth to a child with a birthweight <2.3rd centile from 1 September 2012 to 31 August 2015 in Zealand, Denmark, were included. The population was identified through the Danish Fetal Medicine Database. Medical charts were reviewed to obtain data regarding maternal characteristics and information on the healthcare professionals. Date of authorization for the midwives and obstetricians involved was extracted from the Danish Health Authorization Registry. Multivariable Cox regression models were used to identify predictors of antenatal detection of fetal growth restriction, and analyses were adjusted for hospital, body mass index, parity, the presence of at least one risk factor and experience of the first midwife, number of midwife visits, number of visits to a doctor, the experience of the consultant midwife or the educational level of the doctor, the number of scans and gaps in continuity of midwife‐care. Antenatal detection was defined as an ultrasound estimated fetal weight <2.3rd centile (corresponding to −2 standard deviations) prior to delivery.

Results

Among 78 544 pregnancies, 3069 (3.9%) had a fetal growth restriction. Detection occurred in 31% of fetal growth‐restricted pregnancies. Clinical experience (defined as years since graduation) of the first consultation midwife was positively associated with detection, with a hazard ratio [HR] of 1.15, 95% confidence interval [CI] 1.03‐1.28), for every 10 years of additional experience. The hazard of detection increased with the number of midwife consultations (HR 1.15, 95% CI 1.05‐1.26) and with multiparity (HR 1.28, 95% CI 1.03‐1.58). After adjusting for all covariates, an unexplained difference between hospitals (P = .01) remained.

Conclusions

The low‐risk nullipara may constitute an overlooked group of women at increased risk of antenatal non‐detection of fetal growth restriction. Being screened by experienced midwives during early pregnancy and having access to multiple midwife consultations may improve future diagnosis.
Contesting and envisioning ‘trygghet’: The Sweden Democrats, Social Democrats, and the 2018 Swedish General Election
Authors: Airas Isabel , Truedsson Carl
Published: November 2020

In September 2018, international observers were fixated on Sweden as voters went to the polls. With the national populist party, the Sweden Democrats, predicted to gain significant support, commentators sardonically speculated whether this might finally spell the last bastion of social democracy’s fall from grace? Against the backdrop of the 2015 refugee crisis and growing violent crime rates, would Sweden finally succumb to the emotive appeal of populism? In this paper, we argue for an analysis that starts at the national level to fully appreciate the elements that made Swedish populism unique to its socio‐cultural context. We propose that a geopolitics of language fused with ideas from the ‘affective turn’ is uniquely poised to analyse the deeply affective connotations of territorial metaphors and the structures of feelings associated with them. This is done by showing how the 2018 election centred on competing mobilisations of the Swedish concept of trygghet. This affectively loaded concept, denoting a structure of feeling of comforting and holistic safety, finds no equivalent in the Anglophone world. Taking insights from two ethnographic research projects, conducted with the Sweden Democrats and the Social Democrats, we argue that trygghet serves as a rich socio‐cultural heuristic device that conveys the geohistorical specificities underpinning the 2018 Swedish elections. Indeed, we show the links between the Swedish notions of trygghet and the folkhem (people’s home) to help explain the rise of Swedish populism.
Impact of renal function on hydroxyurea exposure in sickle‐cell disease patients
Authors: Pressiat Claire , Rakotoson Marie‐Georgine , Habibi Anoosha , Barau Caroline , Arrouasse Raphaele , Galactéros Frédéric , Stehlé Thomas , Audard Vincent , Hulin Anne , Bartolucci Pablo
Published: November 2020

Aims

This prospective study aimed to develop a population pharmacokinetics (PK) model of hydroxyurea (HU) in patients with sickle cell disease. This model can be used to determine the impact of glomerular filtration rate (GFR) on HU kinetics.

Methods

We included 30 patients. They underwent HU pharmacokinetics analyses of plasma and urine. Six underwent PK analyses in 2 periods with and without angiotensin‐converting enzyme inhibitor. HU was assayed with a validated high‐performance liquid chromatography‐UV method. Noncompartmental PK analysis was conducted and a population PK model built with Monolix. This model was validated externally on another 56 patients. HU PK was simulated as a function of GFR.

Results

The HU PK model was constructed as a 2‐compartment model with first‐order absorption and elimination. The quality criteria were good, including for external validation. We found that estimated GFR (eGFR) and body weight affected HU PK, with lower eGFR or body weight associated with a higher HU area under the curve. We recommend the monitoring of HU through eGFR and body weight, which together account for 47% of its variability. Urinary HU fractions and renal clearance were higher in the glomerular hyperfiltration group and lower in the moderate chronic kidney disease group, respectively. No differences in nonrenal HU clearance were observed.

Conclusion

Estimated GFR has an impact on the kinetics of hydroxyurea, and HU dose should be adapted accordingly. Angiotensin‐converting enzyme inhibitor seems to have minor effect on HU PK in adults with sickle cell disease.
Withdrawal of hospital outpatient treatments in severe diseases due to unacceptable toxicity: A retrospective study from the register of patients and treatments
Authors: Agustí Antònia , Aguilera Cristina , Bosch Montserrat , Danés Immaculada , Pérez Eulàlia , Vendrell Lourdes , Aller Marta B. , Boixareu Núria , García‐Doladé Núria , Diogène Eduard
Published: November 2020

Aim

To retrospectively analyse hospital outpatient treatment (HOT) withdrawal due to unacceptable toxicity at our hospital. Information regarding unacceptable toxicity leading to treatment withdrawal was recorded.

Methods

HOT interruptions because of unacceptable toxicity were identified from the Register of Patients and Treatments (RPT) (January 2014 to December 2017). Information regarding the demographic and clinical characteristics of patients, adverse drug reactions (ADRs) and drug treatments was retrieved from electronic health records. Causality and previous knowledge of ADRs were assessed according to the Spanish Pharmacovigilance System algorithm. Information regarding HOT risk management plans (RMPs) and their classification as inverted black triangle medicines was obtained from the European Medicines Agency (EMA).

Results

HOTs were withdrawn due to unacceptable toxicity in 136 (1.5%) registries corresponding to 135 (1.7%) patients. Fifty‐one different HOTs (38.6% of those registered) were involved in 240 ADR/HOT pairs: 24 (47%) were additional monitoring medicines and 37 (72.5%) were EMA RMPs. The most frequent medicines involved in ADRs were lenalidomide (30, 12.5%) (mainly neutropenia, thrombocytopenia and bicytopenia), bevacizumab (19, 7.9%) (mainly venous and pulmonary thromboembolism) and sunitinib (13, 5.4%) (mainly thromboembolic events, diarrhoea and worsening of chronic renal failure). Cytopenia (40, 17.3%), diarrhoea (15, 6.5%), asthenia (9, 3.9%) and neuropathy (6, 2.6%) were the most frequent ADRs. All ADRs were severe, 10 (6 patients) had been poorly described or were unknown and only 9 (5 patients) had been reported by spontaneous notification.

Conclusions

Valuable information regarding severe and unknown ADRs was obtained from the RPT. Such registers are useful tools to complement spontaneous ADR notifications.
Oncolytic herpes simplex virus type 1 (HSV‐1) in combination with lenalidomide for plasma cell neoplasms
Authors: Oku Maki , Ishino Ryo , Uchida Shumpei , Imataki Osamu , Sugimoto Naoshi , Todo Tomoki , Kadowaki Norimitsu
Published: November 2020

Oncolytic viruses exert an anti‐tumour effect through two mechanisms: direct oncolytic and indirect immune‐mediated mechanisms. Although oncolytic herpes simplex virus type 1 (HSV‐1) has been approved for melanoma treatment and is being examined for its applicability to a broad spectrum of malignancies, it is not known whether it has an anti‐myeloma effect. In the present study, we show that the third‐generation oncolytic HSV‐1, T‐01, had a direct oncolytic effect on five of six human myeloma cell lines in vitro. The anti‐tumour effect was enhanced in the presence of peripheral blood mononuclear cells (PBMCs) from healthy individuals and, to a lesser extent, from patients with myeloma. The enhancing effect of PBMCs was abrogated by blocking type I interferons (IFNs) or by depleting plasmacytoid dendritic cells (pDCs) or natural killer (NK) cells, suggesting that pDC‐derived type I IFNs and NK cells dominated the anti‐tumour effect. Furthermore, the combination of T‐01 and lenalidomide exhibited enhanced cytotoxicity, and the triple combination of T‐01, lenalidomide and IFN‐α had a maximal effect. These data indicate that oncolytic HSV‐1 represents a viable therapy for plasma cell neoplasms through direct oncolysis and immune activation governed by pDCs and NK cells. Lenalidomide is likely to augment the anti‐myeloma effect of HSV‐1.
Clonal tracking of haematopoietic cells: insights and clinical implications
Authors: Cordes Stefan , Wu Chuanfeng , Dunbar Cynthia E.
Published: November 2020

Recent advances in high‐throughput genomics have enabled the direct tracking of outputs from many cell types, greatly accelerating the study of developmental processes and tissue regeneration. The capacity for long‐term self‐renewal with multilineage differentiation potential characterises the cellular dynamics of a special set of developmental states that are critical for maintaining homeostasis. In haematopoiesis, the archetypal model for development, lineage‐tracing experiments have elucidated the roles of haematopoietic stem cells to ongoing blood production and the importance of long‐lived immune cells to immunological memory. An understanding of the biology and clonal dynamics of these cellular fates and states can provide clues to the response of haematopoiesis to ageing, the process of malignant transformation, and are key to designing more efficacious and durable clinical gene and cellular therapies.
Improved stenosis outcome in stroke‐free sickle cell anemia children after transplantation compared to chronic transfusion
Authors: Verlhac Suzanne , Gabor Flaviu , Paillard Catherine , Chateil Jean‐François , Jubert Charlotte , Petras Marie , Grevent David , Brousse Valentine , Petit Philippe , Thuret Isabelle , Arnaud Cécile , Kamdem Annie , Pondarré Corinne , Gauthier Alexandra , de Montalembert Mariane , Divialle‐Doumdo Lydia , Elmaleh Monique , Missud Florence , Guitton Corinne , Bernaudin Françoise ,   on behaf of the Drepagreffe Investigators
Published: November 2020

We report here the 3‐year stenosis outcome in 60 stroke‐free children with sickle cell anaemia (SCA) and an abnormal transcranial Doppler history, enrolled in the DREPAGREFFE trial, which compared stem cell transplantation (SCT) with standard‐care (chronic transfusion for 1‐year minimum). Twenty‐eight patients with matched sibling donors were transplanted, while 32 remained on standard‐care. Stenosis scores were calculated after performing cerebral/cervical 3D time‐of‐flight magnetic resonance angiography. Fourteen patients had stenosis at enrollment, but only five SCT versus 10 standard‐care patients still had stenosis at 3 years. Stenosis scores remained stable on standard‐care, but significantly improved after SCT (P = 0·006). No patient developed stenosis after SCT, while two on standard‐care did, indicating better stenosis prevention and improved outcome after SCT.
Longitudinal associations of meaning in life and psychosocial adjustment to the COVID‐19 outbreak in China
Authors: Lin Li
Published: November 2020

Objective

Literature suggests that ‘meaning in life’ may be a mental strength that enables individuals to function healthily and adaptively in the face of stress events. Therefore, this study aims to examine the longitudinal associations between meaning in life and psychosocial adjustment to the COVID‐19 outbreak among Chinese people.

Methods

A prospective design was adopted. 154 Chinese college students (Mean age = 20.41 ± 1.45 years) completed two waves of the assessment. Participants reported their meaning in life before the outbreak (Time 1) and their psychosocial adjustment 7 weeks later after the outbreak had occurred (Time 2).

Results

Participants’ meaning in life at Time 1 was positively related to life satisfaction and negatively related to depression, anxiety, stress, and negative emotions at Time 2. Additionally, levels of meaning in life at Time 1 were positively associated to COVID‐19‐related behavioural engagement – prosocial behaviour and information addiction at Time 2. Individuals’ perceptions of the outbreak and status of self‐quarantine did not moderate these relationships.

Conclusion

Findings suggest that individuals’ prior level of meaning in life may help them maintain a healthy psychosocial adjustment during disease outbreak, though cautions regarding the possibility to render an addiction to information about the outbreak are warranted.
Radiographic changes in height and volume after lateral GBR procedures with different ratios of deproteinized bovine bone mineral and autogenous bone at different time points. An experimental study
Authors: Aludden Hanna , Mordenfeld Arne , Cederlund Andreas , Dahlin Christer , Spin‐Neto Rubens , Veiss‐Pedersen Pernille , Sritharan Babyasha , Starch‐Jensen Thomas
Published: November 2020

Objective

Estimate changes in augmentation height and volume after lateral guided bone regeneration (GBR) augmentation with different ratios of deproteinized bovine bone mineral (DBBM) and particulate autogenous bone (PAB) and autogenous bone block (ABB), at different time points.

Material and methods

Twenty‐four minipigs were randomly allocated into three healing periods. Lateral augmentation in 96 sites with standardized quantity of graft material was performed with different ratios of DBBM and PAB (50:50, 75:25, and 100:0) and ABB in combination with DBBM, covered by a collagen membrane. Changes in augmentation height and volume were assessed on CT volumes acquired 10, 20, and 30 weeks after surgery.

Results

Reduction in bone augmentation height was as follows: 50:50–1.7 mm (−33.1%), 75:25–1.8 mm (−37.8%), 100:0–1.7 mm (−35.8%), and ABB ‐ 0.2 mm (−3.7%), after 30 weeks. The augmentation height was significantly better preserved with ABB compared to 50:50, 75:25, and 100:0, while no significant difference was present among particulate grafts. No significant difference in volumetric reduction was found among 50:50, 75:25, 100:0 and ABB after 30 weeks, while 100:0 presented significant less reduction compared to 50:50, 75:25 and ABB after 10 and 20 weeks.

Conclusions

Augmentation height following GBR was better preserved with ABB covered with DBBM. Addition of PAB to DBBM did not affect the changes in height of the graft. The volumetric stability seems to be comparable for ABB covered by DBBM and all particulate grafts after 30 weeks. However, DBBM alone revealed significant less volume reduction in the early healing phase.
Timing and volume of information produced for the Otolaryngologist during the COVID‐19 pandemic in the UK: A review of the volume of online literature
Authors: Cernei Cristina , Shrivastava Manu K. , Colquhoun‐Flannery William , Winter Stuart C.
Published: November 2020

Background

The SARS‐CoV‐2 was first reported in December 2019 in Wuhan, China and has been declared a pandemic in March 2020. COVID‐19 has caused unprecedented and lasting biopsychosocial effects worldwide. All healthcare professionals have faced life‐threatening risks by attending their daily jobs. The daily emergence of advice and guidelines was necessary to ensure the safety of patients and staff. To this effect, all elective services came to a halt to preserve hospitals’ capacity for dealing with the sickest. This retrospective, descriptive review aims to assess the volume and timing of the advice released specifically relevant to UK ENT specialists.

Methods

Two separate searches were performed. One involved online advice published in English by international, national and ENT‐specific organisations between January 1 and May 31. The date, title, source, type of advice and link to the advice were recorded in Excel. The resources were analysed per week of publication. A second separate search for peer‐reviewed publications was conducted using PubMed Central and Cochrane databases.

Findings

COVID‐19‐related guidance was considered, of which 175 were identified. 52/175 (29.7%) articles were published by international organisations. 56/175 (32%) were produced by national organisations, and 67/175 (38.28%) were produced by ENT specific organisations. The peak guidance production took place in the third and fourth week of March (16/03/2020‐29/03/2020) with 72/175 publications. Of these, 27/70 came from the international category, 17/70 from national bodies and 26/70 from ENT‐specific organisations. 13 863 total publications relating to COVID‐19 were found using PubMed and Cochrane search strategies; 76% were relevant to ENT.

Conclusion

The challenges faced by ENT relate to the unprecedented, sudden and daily changes to clinical practice. Multiple bodies interpreted the guidance, giving an opportunity for confusion and delay in treatments for patients. Implementing a system with clear lines of communication and dissemination of information will improve our response to future pandemic events whilst maintaining a commercial awareness to better use the human and financial resources of an already financially restricted NHS.
The same storm but not the same boat: Effects of COVID‐19 stay‐at‐home order on mental health in individuals with overweight
Authors: Lofrano‐Prado Mara C. , do Prado Wagner Luiz , Botero Joao Paulo , Cardel Michelle L. , Farah Breno Q. , Oliveira Max D. , Cucato Gabriel G. , Correia Marilia A. , Ritti‐Dias Raphael M.
Published: November 2020

Objective

To describe the effects of stay‐at‐home orders and social distancing during the coronavirus disease (COVID‐19) outbreak on mental health and to compare these outcomes between individuals with normal weight and overweight.

Methods

This cross‐sectional study included 1857 Brazilian adults, who were invited through social media to answer an online questionnaire from 5 May 2020 to 17 May 2020. The instrument included questions related to health behaviour, mental health (anxiety, depression, self‐esteem, sadness and stress) and overall health. Overweight was defined as body mass index (BMI) ≥ 25 Kg/m2. Multiple logistic regression was conducted to identify whether overweight is associated with mental health variables.

Results

Women reported increased anxiety (36.5% vs 22.2%, P < .01), depression (16.2% vs 8.8%, P < .01), low self‐esteem (19.8% vs 10.6%, P < .01), sadness (17.7% vs 10.2%, P < .01), and stress (29.5% vs 19.3%, P < .01) relative to men. Women with overweight are more likely to report higher feeling of anxiety (OR 1.62, CI 95% 1.22‐2.14), depression (OR 1.79, CI 95% 1.25‐2.55), low self‐esteem (OR 1.82, CI95% 1.28‐2.58) and sadness (OR 1.51, CI 95% 1.08‐2.10), adjusted for age, social isolation days, educational level, chronic diseases, smoke, alcohol intake and physical activity.

Conclusion

Women, specially those with overweight are more vulnerable to the deleterious effects of stay‐at‐home orders on mental health during the COVID‐19 pandemic.
Expression of the core promoter factors TATA box binding protein and TATA box binding protein‐related factor 2 in Drosophila germ cells and their distinct functions in germline development
Authors: Nakamura Shoichi , Hira Seiji , Kojima Makoto , Kondo Akane , Mukai Masanori
Published: November 2020

In Drosophila, the expression of germline genes is initiated in primordial germ cells (PGCs) and is known to be associated with germline establishment. However, the transcriptional regulation of germline genes remains elusive. Previously, we found that the BTB/POZ‐Zn‐finger protein, Mamo, is necessary for the expression of the germline gene, vasa, in PGCs. Moreover, truncated Mamo lacking the BTB/POZ domain (MamoAF) is a potent vasa activator. In this study, we investigated the genetic interaction between MamoAF and specific transcriptional regulators to gain insight into the transcriptional regulation of germline development. We identified a general transcription factor, TATA box binding protein (TBP)‐associated factor 3 (TAF3/BIP2), and a member of the TBP‐like proteins, TBP‐related factor 2 (TRF2), as new genetic modifiers of MamoAF. In contrast to TRF2, TBP was found to show no genetic interaction with MamoAF, suggesting that Trf2 has a selective function. Therefore, we focused on Trf2 expression and investigated its function in germ cells. We found that Trf2 mRNA, rather than Tbp mRNA, was preferentially expressed in PGCs during embryogenesis. Depletion of TRF2 in PGCs resulted in decreased mRNA expression of vasa. RNA interference‐mediated knockdown showed that, while Trf2 is required for maintenance of germ cells, Tbp is needed for their differentiation during oogenesis. Therefore, these results suggest that Trf2 and Tbp expression is differentially regulated in germ cells and that these factors have distinct functions in Drosophila germline development.
WORKING BEAUTIFULLY: DESIGN IS FAILING TO FULLY LIVE UP TO ITS IDEALS. COULD RESTORING ITS LONG‐LOST EMBRACE OF BEAUTY HELP?
Authors: Hendricks Nathan
Published: November 2020

Plato famously considered the three foundational human values to be truth, goodness, and beauty. He further asserted that the absence of one disqualified the others.
Design Thinking For Organizational Change
Authors: Wuertz Hal , Eshbaugh Scott , Nelson Sarah B.
Published: November 2020

Our experience had shown that when client engagements were led with design thinking, they were the most enduring, most lucrative, and highest client‐rated experiences we delivered.
High‐dose methylprednisolone in nonintubated patients with severe COVID‐19 pneumonia
Authors: Papamanoli Aikaterini , Yoo Jeanwoo , Grewal Prabhjot , Predun William , Hotelling Jessica , Jacob Robin , Mojahedi Azad , Skopicki Hal A. , Mansour Mohamed , Marcos Luis A. , Kalogeropoulos Andreas P.
Published: November 2020

Background

Recent trials with dexamethasone and hydrocortisone have demonstrated benefit in patients with coronavirus disease 2019 (COVID‐19). Data on methylprednisolone are limited.

Methods

Retrospective cohort of consecutive adults with severe COVID‐19 pneumonia on high‐flow oxygen (FiO2 ≥ 50%) admitted to an academic centre in New York, from 1 March to 15 April 2020. We used inverse probability of treatment weights to estimate the effect of methylprednisolone on clinical outcomes and intensive care resource utilization.

Results

Of 447 patients, 153 (34.2%) received methylprednisolone and 294 (65.8%) received no corticosteroids. At 28 days, 102 patients (22.8%) had died and 115 (25.7%) received mechanical ventilation. In weighted analyses, risk for death or mechanical ventilation was 37% lower with methylprednisolone (hazard ratio 0.63; 95% CI 0.47‐0.86; P = .003), driven by less frequent mechanical ventilation (subhazard ratio 0.56; 95% CI 0.40‐0.79; P = .001); mortality did not differ between groups. The methylprednisolone group had 2.8 more ventilator‐free days (95% CI 0.5‐5.1; P = .017) and 2.6 more intensive care‐free days (95% CI 0.2‐4.9; P = .033) during the first 28 days. Complication rates were not higher with methylprednisolone.

Conclusions

In nonintubated patients with severe COVID‐19 pneumonia, methylprednisolone was associated with reduced need for mechanical ventilation and less‐intensive care resource utilization without excess complications.
Spatial variation in early‐winter snow cover determines local dynamics in a network of alpine butterfly populations
Authors: Roland Jens , Filazzola Alessandro , Matter Stephen F.
Published: November 2020

Snow cover is an extremely variable but critical component of alpine environments. We use long term population data on multiple small populations of the alpine butterflyParnassius smintheus, combined with high‐resolution satellite imagery of meadows, to show a strong link between fine‐scale spatial and temporal variation in early‐winter snow cover and annual change in butterfly population size, accounting for up to 80 percent of the variation in annual population change. Snow cover in early winter for each meadow is the best predictor of annual adult population change, despite being estimated for a relatively short time‐window in late November. We identify a means by which subpopulation response to a local, short‐term weather variable can be assessed over a large spatial extent, but also at a resolution relevant to the biology and local dynamics of this alpine species.
Dentoalveolar injuries, bicycling accidents and helmet use in patients referred to a Norwegian Trauma Centre: A 12‐year prospective study
Authors: Døving Mats , Galteland Pål , Eken Torsten , Sehic Amer , Utheim Tor Paaske , Skaga Nils Oddvar , Helseth Eirik , Ramm‐Pettersen Jon
Published: November 2020

Background/Aim

Despite its many benefits, bicycling carries the risk of accidents. Although numerous studies have reported the effect of helmet use on traumatic brain injury, it remains unclear if, and to what extent, helmet use reduces the risk of facial injuries. This is particularly true in regard to injuries of the lower face. In addition, there is limited evidence of the effect of helmet use on dentoalveolar injuries. Thus, the aim of this study was to determine the frequency and distribution of dentoalveolar injuries in bicycling accidents and to explore the influence of helmet use.

Material and Methods

A total of 1543 bicyclists were included from the trauma registry of a Norwegian tertiary trauma center over a 12‐year period. Data were collected prospectively, including patient characteristics, type of injury, and helmet use. The prevalence of dentoalveolar injuries was assessed in conjunction with helmet use and facial fractures.

Results

Twenty‐five percent of the patients had maxillofacial injuries, and 18% of those with facial fractures exhibited concomitant dentoalveolar injuries. The most common type of dentoalveolar injury was tooth fracture (39%). The most frequent location of facial fractures with combined dentoalveolar injuries was the maxilla, which had fractured in 32 patients. Women had a higher risk of sustaining dentoalveolar injuries compared to men (odds ratio 1.50, 95% confidence interval 1.02‐2.22). There were 1257 patients (81%) who had reliable registration of helmet use; 54% of these wore a helmet, while 46% did not. Helmet users had an increased risk of dentoalveolar injuries compared to non‐helmeted bicyclists (adjusted odds ratio 1.54, 95% confidence interval 1.02‐2.31).

Conclusions

Dentoalveolar injuries are fairly common in trauma patients admitted to a trauma center following bicycling accidents. Bicycling helmets are associated with an increased risk of dentoalveolar injuries.
Conservative management of pediatric mandibular distal fractures—A retrospective study
Authors: Mittal Hitesh Chander , Yadav Sunil , Shekhawat Himanshu
Published: November 2020

Background/Aim

Pediatric mandibular distal fractures present unique treatment challenges which are usually managed with open reduction and internal fixation (ORIF) with the risk of developing tooth bud injuries. Conservative management through maxillomandibular fixation (MMF) with orthodontic bracket‐elastic as an out‐patient department (OPD) service has been used for these fractures presenting with derangement of occlusion. The aim of this study was to retrospectively analyze MMF with orthodontic bracket‐elastic as a treatment method and its outcome for management of pediatric mandibular distal fractures.

Methodology

Data of seventeen pediatric cases diagnosed with displaced mandibular distal fractures managed with MMF with orthodontic bracket‐elastic over a period of 5 years were analyzed. In this technique, two weeks of immobilization and one week for guiding elastics were used.

Results

The mean age of patients was 7.6 ± 1.6 years with a mean follow‐up of 24 months. All fractures healed uneventfully with satisfactory occlusion. The cases included 23.5% minimally displaced, and 64.7% moderately displaced and 11.8% significantly displaced fractures with step deformity with successful remodeling of the lower border contours over a duration of 18 months ± 1 month. The developing tooth buds in the fracture line showed no complications except for root dilacerations/malformation (n = 3).

Conclusion

MMF with orthodontic bracket‐elastic is a viable and conservative technique for the management of pediatric mandibular distal fractures which need to be verified through randomized trials for generalization of the results.
Influence of ceramic veneer thickness and antagonist on impact stresses during dental trauma with and without a mouthguard assessed with finite element analysis
Authors: Bragança Gabriel Felipe de , Vilela Andomar Bruno Fernandes , Soares Priscilla Barbosa Ferreira , Tantbirojn Daranee , Versluis Antheunis , Soares Carlos José
Published: November 2020

Background/Aim

Little is known about the effect of dental trauma and mouthguards (MG) on teeth with ceramic laminate veneers (CLV). The aim was to evaluate the influence of CLV thickness and the presence of a MG with and without antagonist tooth contact on impact stresses during dental trauma.

Materials and Methods

Twelve 2D‐finite element models of a head with maxillary structures and upper incisors, six with and six without antagonist tooth, were created in three CLV conditions: sound incisor (no CLV), 0.3 mm CLV, and 1.0 mm CLV. These were evaluated with and without a 4.0‐mm ethylene‐vinyl acetate MG, with and without an antagonist tooth. An impact analysis was performed in which the head frontally hits a rigid surface at a speed of 1 m/s (3.6 km/h). The results were analyzed using Critical modified von Mises (MPa). The mean of the 10% highest modified von Mises stresses in each structure was collected.

Results

MG presence substantially reduced impact stresses in the CLV and tooth structures. The contact of the antagonist tooth promoted better stress distribution and reduced the stress levels in the traumatized tooth. Critical stress areas were found in the palatal enamel, incisal enamel, labial cervical area, and enamel under the CLV for all models without MG. In the models with MG, the stresses reduced significantly. Critical modified von Mises stress showed that sound or prepared enamel experienced more critical impact stresses than 0.3 or 1.0‐mm thick CLV.

Conclusions

The use of 4.0 mm EVA mouthguard reduced the impact stress levels in models with 0.3‐mm CLV and 1.0‐mm CLV, similar to a sound tooth. The contact of an antagonist tooth and the MG better distributed the stresses and reduced the impact stress in the traumatized tooth.
Traumatic dental injuries and pulp sequelae in an adolescent population
Authors: Bratteberg Magnus , Thelen Dorina S. , Klock Kristin S. , Bårdsen Asgeir
Published: November 2020

Background/Aims

Traumatic dental injuries (TDI) occur frequently and may result in pulp sequelae. This includes pulp necrosis with infection, pulp canal obliteration and root resorption. The aim of this study was to assess the prevalence and risk factors of pulp sequelae after TDI among Norwegian adolescents.

Material and methods

A retrospective longitudinal study, including historical clinical data, was conducted with 16‐year‐old pupils in western Norway. All first‐grade pupils, born in 1997 (n = 5184), attending public high schools, were invited to participate and to respond to an electronically administered closed‐ended questionnaire (response rate 39.6%, n = 2055). Consent was given to access the dental records in the Public Dental Health Service in Hordaland, where information regarding TDI (diagnosis and treatment) and radiographs were interpreted. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible). Outcome variables of TDI were registered and analysed using logistic regression, Kaplan‐Meier survival estimates and log‐rank test.

Results

The prevalence of TDI in the sample population was 16.4% (338 pupils), with a total of 637 teeth involved. The number of included teeth for analysis was 571 (90.5%). The prevalence of pulp necrosis with infection was 7.5%. Moderate and severe TDI was associated with a higher frequency of pulp necrosis with infection. Pulp canal obliteration and root resorption were found in 2.8% and 2.3% of teeth with TDI, respectively. Dental hard tissue injuries were more prone to the development of pulp necrosis than luxation injuries and combination injuries. The relationship between root development stage and development of pulp necrosis with infection was not statistically significant.

Conclusions

Occurrence of different pulp sequelae among teeth affected with TDI was low. Moderate and severe TDI were more at risk of developing pulpal complications and hard tissue injuries were at higher risk of developing pulp necrosis with infection.
Radiation exposure causes developmental alterations in size and shape of wings and structures associated with song production in male crickets (Acheta domesticus)
Authors: Fuciarelli Tamara M. , Rollo C. David
Published: November 2020

Environmental disasters and growth of nuclear power contribute to increasing levels of radiation pollution in the biosphere. Major impacts concern development, fertility, and survivorship in diverse species. Subtle impacts are less appreciated even though they may have profound effects on individuals and populations. Here, we examined radiation impacts on male crickets, Acheta domesticus (L.) (Orthoptera: Gryllidae), specific to wing development. Alterations in global wing morphology are detectable, but this is a flightless species. However, mating success of males is highly dependent on specialized courtship songs generated by structures associated with the opposing forewings. Such signals identify males as both conspecific and ‘attractive/fit’ mates. Highly specialized structures found on male forewings include the chord, harp, mirror, plectrum, and file. These work in concert to generate the species‐specific male courtship song. Even slight alterations in wing morphology can alter these signals, and variation may also vary acoustic signals among populations. Here, we analyze the impacts of early‐life radiation exposure (0–10 Gy) on male forewing shape and size using morphometric analysis. A canonical variate analysis (CVA) illustrated that wing shape was significantly altered in a dose‐dependent basis: 10 Gy (P<0.0001), 7 Gy (P<0.0001), and 2 Gy (P = 0.0001). Principal component (PC) analysis as well as the CVA indicated that most variation in wing structure was associated with the mirror, one of the two main resonating regions on the forewing. Analysis of centroid size found significant reductions with 7 and 10 Gy radiation exposures. Significant radiation‐induced increases in fluctuating asymmetry were also detected, with fluctuating asymmetry values increasing with dose. Due to the known specialized nature of song‐producing structures and its association with both courtship songs and mating, it is likely that the alterations observed in shape and size will have larger impacts on male reproductive success. We are currently quantifying this and analyzing recordings of song structure to detect and characterize specific alterations by radiation.
The interplay between executive control, behavioural variability and mind wandering: Insights from a high‐definition transcranial direct‐current stimulation study
Authors: Boayue Nya M. , Csifcsák Gábor , Kreis Isabel V. , Schmidt Carole , Finn Iselin , Hovde Vollsund Anna E. , Mittner Matthias
Published: November 2020

While the involvement of executive processes in mind wandering is largely undebated, their exact relationship is subject to an ongoing debate and rarely studied dynamically within‐subject. Several brain‐stimulation studies using transcranial direct current stimulation (tDCS) have attempted to modulate mind‐wandering propensity by stimulating the left dorsolateral prefrontal cortex (DLPFC) which is an important hub in the prefrontal control network. In a series of three studies testing a total of N = 100 participants, we develop a novel task that allows to study the dynamic interplay of mind wandering, behavioural varibility and the flexible recruitment of executive resources as indexed by the randomness (entropy) of movement sequences generated by our participants. We consistently find that behavioural variability is increased and randomness is decreased during periods of mind wandering. Interestingly, we also find that behavioural variability interacts with the entropy‐MW effect, opening up the possibility to detect distinct states of off‐focus cognition. When applying a high‐definition transcranial direct‐current stimulation (HD‐tDCS) montage to the left DLPFC, we find that propensity to mind wander is reduced relative to a group receiving sham stimulation.
Neural target selection as a marker of real‐world familiarity during search for perceptually distinct objects
Authors: Ferguson Leah , Ahmed Claire , Dang Christine , Wu Rachel
Published: November 2020

Prior studies have shown that behavioral performance is better when detecting specific familiar items based on real‐world experience (e.g., an own‐age face, a specific bird for bird experts), compared to less familiar items (e.g., an other‐age face). These biases emerge from exposure to and interactions with initially less familiar items, which allow for better discrimination and search (e.g., finding an other‐age face in a crowd). However, many broad categories in the natural environment (e.g., vintage objects, exotic fruit) contain perceptually distinct items that people can accurately search for individually, even if the objects are not as familiar. How might real‐world familiarity impact search in these cases? Recent studies suggest that the N2pc event‐related potential (ERP, neural marker of target selection) may be more sensitive than behavioral performance in reflecting prior knowledge, and perhaps familiarity, during visual search. In two experiments, the present study investigated the behavioral effects (Experiment 1) and N2pc effects (Experiment 2) of searching for distinct familiar (modern) versus less familiar (vintage) objects in younger adults. Experiment 1 also included a sample of older adults, who were familiar with both types of objects. Overall, the behavioral results did not reveal robust differences in searching for modern versus vintage objects. However, the N2pc in younger adults was present when searching for modern objects, but not for vintage objects. The N2pc results suggest that this neural marker may be more sensitive than behavioral measures in reflecting familiarity from real‐world experiences with object categories.
“Where ignorance is bliss, 'tis folly to be wise”: Indiscriminate male care in a neotropical spider
Authors: Moura Rafael Rios , Oliveira Isabella Dias , Vasconcellos‐Neto João , Gonzaga Marcelo Oliveira
Published: November 2020

Certainty of paternity is considered an important condition for the evolution and maintenance of extended male care. In some species, males may cannibalize unrelated offspring or abandon the progeny when the uncertainty of paternity is high, or when they take over nest sites or females from other males. However, male protection of offspring can also evolve in situations of uncertainty of paternity, especially when males cannot recognize offspring relatedness. In such cases, males may take care of all their mate's offspring, regardless of paternity. In Manogea porracea (Araneidae), the only known spider species where males care for offspring, males repel competitors by assuming and defending specific positions within a female's web, but females accept multiple partners during the reproductive season. Consequently, males may care for some offspring produced with the sperm of their mate's previous partners. If males cannot detect offspring relatedness, we expect that they will not cannibalize progeny and will actively protect all offspring against predation. The main goal of this study was to investigate whether the extended male care depends on offspring relatedness recognition. Therefore, we experimentally manipulated offspring relatedness and the presence of foster males and two egg predators usually found invading M. porracea webs. We also compared our results with data from an experiment performed by Moura, Vasconcellos‐Neto, & Gonzaga (2017) using the same laboratory procedures, but introducing egg sacs fathered exclusively by the males. Males did not cannibalize offspring and protected the progeny against predation regardless of offspring relatedness. In addition, all males moved the egg sacs to the center of the web, remaining close to the progeny. We conclude that M. porracea males protect all progeny present in their partner's web and increase offspring survivorship regardless of relatedness. We discuss the behavioral and evolutionary implications of our findings, and potential triggers of male care in M. porracea.
The effects of flumazenil on ventilatory and recovery characteristics in horses following midazolam‐ketamine induction and isoflurane anaesthesia
Authors: Douglas Hope , Hopster Klaus , Cerullo Michelle , Hopster‐Iversen Charlotte , Stefanovski Darko , Driessen Bernd
Published: November 2020

Background

Flumazenil antagonises the actions of benzodiazepines. There has been no prior research specifically investigating this anaesthetic reversal agent for horses.

Objectives

To determine the effects of flumazenil administration in horses on (a) ventilatory parameters after midazolam‐ketamine induction and maintenance with isoflurane in oxygen and on (b) the characteristics of recovery from general anaesthesia.

Study design

Blinded, randomised, crossover experiment.

Methods

Six horses were randomly assigned to receive high‐dose flumazenil (Fhigh, 20 µg/kg), low‐dose flumazenil (Flow, 10 µg/kg) and saline (control). Cardioventilatory parameters were monitored. After 90 minutes of isoflurane anaesthesia, a bolus of Fhigh, Flow or saline was administered i.v. The horses were recovered using head and tail rope assistance. The times to first movement, to achievement of sternal recumbency, to the first attempt to stand and the total recovery time were determined. The recovery quality was evaluated using a 115‐point recovery scoring system. The cardioventilatory parameters and recovery times were analysed using mixed‐effects regression analyses. Intraclass correlation (ICC) analysis was used to evaluate the recovery scores. A Mann‐Whitney U test assessed the relationship between recovery score and flumazenil administration.

Results

A significant difference with flumazenil administration was found for SpO2, mean arterial pressure, I:E ratio, minute volume of ventilation (MV) and peak inspiratory pressure. There was a significant difference with flumazenil administration for the time to sternal recumbency, the time to the first attempt to rise and the total recovery time. There was no significant difference in total recovery score with flumazenil administration.

Main limitations

Plasma levels of midazolam and flumazenil were not obtained.

Conclusions

Flumazenil has a dose‐dependent effect on MV and recovery time, which may make it useful in cases for which a prolonged anaesthetic recovery is undesirable.
Stress‐Buffering Role of Social Support during COVID‐19
Authors: Szkody Erica , Stearns Melanie , Stanhope Lydia , McKinney Cliff
Published: November 2020

In order to reduce the high infection rate of COVID‐19, individuals began to engage in self‐isolation amid a time of uncertainty and worry. Given that social support can be protective against the negative effects of distress on mental and physical health, the lack of support may negatively impact individuals during their self‐isolation. Thus, the current study examined the role of self‐isolation on feelings of stress, the perception and reception of social support, and mental health problems during the COVID‐19 pandemic. A sample of 405 college students were asked to report on the amount of self‐isolation in which they were engaging, worry about COVID‐19, psychological health, and received and perceived social support. Results indicated that when the length of time in self‐isolation was taken into account, perceived social support buffered the connection between worry about COVID‐19 and psychological health. These results indicate that social support, worry about COVID‐19, and self‐isolation may influence individuals’ psychological health during times of stress.