bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of severe acute respiratory syndrome coronavirus 2 on ectopic pregnancy management in the United Kingdom: a multicentre observational study
Authors: Platts S , Ranawaka J , Oliver R , Patra‐Das S , Kotabagi P , Neophytou C , Shah N , Toal M , Bassett P , Davison A , Gbegbaje M , Rao K , Rouabhi S , Watson S , Odejinmi F
Published: May 2021

Objective

To describe the impact of coronavirus disease 2019 (COVID‐19) on the management of women with ectopic pregnancy.

Design

A multicentre observational study comparing outcomes from a prospective cohort during the pandemic [COVID‐19‐ectopic pregnancy registry (CEPR)] compared with a historical pre‐pandemic cohort [non‐COVID‐19‐ectopic pregnancy registry (NCEPR)].

Setting

Five London university hospitals.

Population and methods

Consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March 2020–August 2020) were entered into the CEPR and results were compared with the NCEPR cohort (January 2019–June 2019). An adjusted analysis was performed for potentially confounding variables.

Main outcome measures

Patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non‐surgical management), length of stay (surgical management) and 30‐day complications.

Results

Three hundred and forty‐one women met the inclusion criteria: 162 CEPR and 179 NCEPR. A significantly lower percentage of women underwent surgical management versus non‐surgical management in the CEPR versus NCEPR (58.6%; 95/162 versus 72.6%; 130/179; P = 0.007). Among patients managed with expectant management, the CEPR had a significantly lower mean number of hospital visits compared with NCEPR (3.0, interquartile range [IQR] [3, 5] versus 9.0, [5, 14]; P = <0.001). Among patients managed with medical management, the CEPR had a significantly lower median number of hospital visits versus NCEPR (6.0, [5, 8] versus 9, [6, 10]; P = 0.003). There was no observed difference in complication rates between cohorts.

Conclusion

Women were found to undergo significantly higher rates of non‐surgical management during the COVID‐19 first wave compared with a pre‐pandemic cohort. Women managed non‐surgically in the CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complication rates.

Tweetable abstract

A higher rate of non‐surgical management of ectopic pregnancy during the COVID‐19 pandemic did not increase complication rates.
Avoiding the Road to Nowhere: Policy Insights on Scaling up and Sustaining Digital Health
Authors: LeFevre Amnesty , Chamberlain Sara , Singh Neha S. , Scott Kerry , Menon Purnima , Barron Peter , Ved Rajani R. , George Asha
Published: May 2021

Digital health solutions offer tremendous potential to enhance the reach and quality of health services and population‐level outcomes in low‐ and middle‐income countries (LMICs). While the number of programs reaching scale increases yearly, the long‐term sustainability for most remains uncertain. In this article, as researchers and implementors, we draw on experiences of designing, implementing and evaluating digital health solutions at scale in Africa and Asia, and provide examples from India and South Africa to illustrate ten considerations to support scale and sustainability of digital health solutions in LMICs. Given the investments being made in digital health solutions and the urgent concurrent needs to strengthen health systems to ensure their responsiveness to marginalized populations in LMICs, we cannot afford to go down roads that ‘lead to nowhere’. These ten considerations focus on drivers of equity and innovation, the foundations for a digital health ecosystem, and the elements for systems integration. We urge technology enthusiasts to consider these issues before and during the roll‐out of large‐scale digital health initiatives to navigate the complexities of achieving scale and enabling sustainability.
Partner influence as a factor in maternal alcohol consumption and depressive symptoms, and maternal effects on infant neurodevelopmental outcomes
Authors: Kautz‐Turnbull Carson , Petrenko Christie L. M. , Handley Elizabeth D. , Coles Claire D. , Kable Julie A. , Wertelecki Wladimir , Yevtushok Lyubov , Zymak‐Zakutnya Natalya , Chambers Christina D. ,   the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD)
Published: May 2021

Background

Few studies have investigated the partner's influence on risk factors such as alcohol consumption and depression during pregnancy. Partner substance use and lower relationship satisfaction predict higher maternal alcohol use and depressive symptoms. Because prenatal alcohol use and maternal depression affect infant outcomes, it is imperative to examine how the partner affects these maternal risk factors. The current study examined the effect of a latent construct of partner influence on maternal alcohol use and depressive symptoms, and the effects on infant development of these maternal factors.

Methods

Participants were 246 pregnant women from 2 sites in Western Ukraine from whom longitudinal data were collected as part of a multisite study. In the first trimester, mothers reported on relationship satisfaction, partner substance use, and socioeconomic status (SES). In the third trimester, they reported on alcohol use and depressive symptoms. Infants were assessed using the Bayley Scale of Infant Development (average age = 6.93 months). A latent construct titled partner influence was formed using partner substance use and measures of relationship satisfaction, including the frequency of quarreling, happiness in the relationship, and the ease of talking with the partner. Using structural equation modeling, a model was specified in which partner influence and SES predicted maternal alcohol use and depressive symptoms, which in turn predicted infant neurodevelopmental outcomes.

Results

Higher partner influence significantly predicted lower prenatal alcohol use and lower depressive symptoms, controlling for the effect of SES. Higher maternal prenatal alcohol use significantly predicted lower infant mental and psychomotor development. Maternal depressive symptoms did not predict infant development over and above the effect of alcohol use.

Conclusions

Partner influence is an important contributor to prenatal alcohol use and maternal depressive symptoms, over and above the effect of SES. The significant paths from prenatal alcohol exposure to infant neurodevelopmental outcomes underscore the importance of partner influence during pregnancy.
Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration
Authors: Ching Jack H. , Owens Douglas K. , Trafton Jodie A. , Goldhaber‐Fiebert Jeremy D. , Salomon Joshua A.
Published: May 2021

Background and aims

While long‐term medication‐assisted treatment (MAT) using methadone or buprenorphine is associated with significantly lower all‐cause mortality for individuals with opioid use disorder (OUD), periods of initiating or discontinuing treatment are associated with higher mortality risks relative to stable treatment. This study aimed to identify the OUD treatment durations necessary for the elevated mortality risks during treatment transitions to be balanced by reductions in mortality while receiving treatment.

Design

Simulation model based on a compartmental model of OUD diagnosis, MAT receipt and all‐cause mortality among Veterans with OUD in the United States Veterans Health Administration (VA) in 2017–2018. We simulated methadone and buprenorphine treatments of varying durations using parameters obtained through calibration and published meta‐analyses of studies from North America, Europe and Australia.

Setting

United States.

Participants

Simulated cohorts of 10 000 individuals with OUD.

Measurements

All‐cause mortality over 12 months.

Findings

Receiving methadone for 4 months or longer or buprenorphine for 2 months or longer resulted in 54 [95% confidence interval (CI) = 5–90] and 65 (95% CI = 21–89) fewer deaths relative to not receiving MAT for the same duration, using VA‐specific mortality rates. We estimated shorter treatment durations necessary to achieve net mortality benefits of 2 months or longer for methadone and 1 month or longer for buprenorphine, using non‐VA population literature estimates. Sensitivity analyses demonstrated that necessary treatment durations increased more with smaller mortality reductions on treatment than with larger relative risks during treatment transitions.

Conclusions

Short periods (< 6 months) of treatment with either methadone or buprenorphine are likely to yield net mortality benefits for people with opioid use disorder relative to receiving no medications, despite periods of elevated all‐cause mortality risk during transitions into and out of treatment. Retaining people with opioid use disorder in treatment longer can increase these benefits.
The effect of statins on semen parameters in patients with hypercholesterolemia: A systematic review
Authors: Anagnostis Panagiotis , Papanikolaou Dimitrios , Ioannidou Pinelopi G. , Bosdou Julia K. , Mikhailidis Dimitri P. , Hatzimouratidis Konstantinos , Goulis Dimitrios G.
Published: May 2021

Background

Statins constitute the mainstay of treatment in patients with hypercholesterolemia. However, their effect on semen parameters is unknown.

Objective

This study aimed to systematically review the best available evidence regarding the effect of statins on ejaculate volume and sperm concentration, motility, morphology, or vitality.

Materials/Methods

A comprehensive search was conducted in PubMed, CENTRAL and Scopus databases up to January 10, 2021. Either randomized‐controlled trials or prospective cohorts, conducted in males with hypercholesterolemia, were included.

Results

Four studies, published between 1992 and 2014, were eligible. The number of participants ranged from 8 to 120 (n = 161). Study duration ranged from 14 to 48 weeks. The type and dose of statin used were pravastatin 20–80 mg/day and simvastatin 20–40 mg/day.

With regard to ejaculate volume (n = 3) and sperm concentration (n = 4), no effect was shown with either pravastatin or simvastatin. Regarding sperm motility, either an increase (n = 2; pravastatin, simvastatin), decrease (n = 1; pravastatin), or no effect (n = 1; pravastatin, simvastatin) was found. With respect to sperm morphology, either a decrease (n = 2; pravastatin, simvastatin) or no effect (n = 2; pravastatin, simvastatin) was shown. Concerning sperm vitality, a single study showed a decrease with simvastatin.

Because of the high heterogeneity of the populations studied and the limited number of studies, a meta‐analysis was not performed.

Conclusion

This is the first systematic review on the effect of statins on semen parameters. As there is no evidence for such a detrimental effect, no specific approach has to be suggested regarding the preservation of reproductive function in men with hypercholesterolemia.
Hyperprolactinemia in a male pituitary androgen receptor knockout mouse is associated with female‐like lactotroph development
Authors: O’Hara Laura , Christian Helen C. , Le Tissier Paul , Smith Lee B.
Published: May 2021

Background

Circulating prolactin concentration in rodents and humans is sexually dimorphic. Oestrogens are a well‐characterised stimulator of prolactin release. Circulating prolactin fluctuates throughout the menstrual/oestrous cycle of females in response to oestrogen levels, but remains continually low in males. We have previously identified androgens as an inhibitor of prolactin release through characterisation of males of a mouse line with a conditional pituitary androgen receptor knockout (PARKO) which have an increase in circulating prolactin, but unchanged lactotroph number.

Objectives

In the present study, we aimed to specify the cell type that androgens act on to repress prolactin release.

Materials and methods

PARKO, lactotroph‐specific, Pit1 lineage‐specific and neural‐specific conditional androgen receptor knockout male mice were investigated using prolactin ELISA, pituitary electron microscopy, immunohistochemistry and qRT‐PCR.

Results

Lactotroph‐specific, Pit1 lineage‐specific and neural‐specific conditional AR knockouts did not duplicate the high circulating prolactin seen in the PARKO line. Using electron microscopy to examine ultrastructure, we showed that pituitary androgen receptor knockout male mice develop lactotrophs that resemble those seen in female mice. Castrated PARKO males have significantly reduced circulating prolactin compared to intact males. When expression of selected oestrogen‐regulated anterior pituitary genes was examined, there were no differences in expression level between controls and knockouts.

Discussion

The cell type that androgens act on to repress prolactin release is not the lactotroph, cells in the Pit1‐lineage, or the dopaminergic neurons in the hypothalamus. PARKO males develop a female‐specific lactotroph ultrastructure that this is likely to contribute to the increase in circulating prolactin. Castrated PARKO males have significantly reduced circulating prolactin compared to intact males, which suggests that removal of both circulating oestrogens and androgens reduces the stimulation of pituitary prolactin release.

Conclusion

Further investigation is needed into prolactin regulation by changes in androgen‐oestrogen balance, which is involved sexual dimorphism of development and diseases including hyperprolactinemia.
Globally intensity‐reweighted estimators forK‐ and pair correlation functions
Authors: Shaw Thomas , M⊘ller Jesper , Waagepetersen Rasmus Plenge
Published: May 2021

We introduce new estimators of the inhomogeneousK‐function and the pair correlation function of a spatial point process as well as the crossK‐function and the cross pair correlation function of a bivariate spatial point process under the assumption of second‐order intensity‐reweighted stationarity. These estimators rely on a ‘global’ normalisation factor which depends on an aggregation of the intensity function, while the existing estimators depend ‘locally’ on the intensity function at the individual observed points. The advantages of our new global estimators over the existing local estimators are demonstrated by theoretical considerations and a simulation study.
Impact of exercise on pain perception in women with endometriosis: A systematic review
Authors: Hansen Sara , Sverrisdóttir Una Á. , Rudnicki Martin
Published: May 2021

Introduction

Endometriosis is challenging to treat. It is a painful and chronic inflammatory disorder that impacts up to 10% of women of reproductive age. Despite available surgical and medical treatment options, recurrence of symptoms is common. Available studies suggest that exercise may have a therapeutic effect on chronic inflammation and thereby on pain perception. This review evaluates whether exercise can decrease pain perception in women with symptomatic endometriosis.

Material and methods

This systematic review was conducted according to PRISMA by searching databases Medline and Embase to locate randomized controlled trials and observational studies. Risk of bias was investigated using the Cochrane Collaboration Tool for the Evaluation of Randomized Controlled Trials and the ROBINS‐I quality assessment scale. Inclusion criteria were women of reproductive age, laparoscopically confirmed diagnosis of endometriosis, and intervention of any type of exercise. All manuscripts were evaluated by two of the authors and when in doubt a third author was consulted. This review was registered in PROSPERO on November 14, 2020 (CRD42020212309).

Results

Six articles fulfilled the inclusion criteria and were included in this systematic review. Concerning exercise, two studies showed significant decrease in pain relief but the remaining studies showed either negative or no impact on pain relief. A meta‐analysis could not be conducted because of the considerable heterogeneity among the included studies.

Conclusions

The present review does not indicate any beneficial effect of exercise on pain in women with endometriosis. There is a need for randomized controlled trials with correct power calculation, well‐defined study groups and training programs to be able to answer the question of whether exercise can improve the pain experience in patients with endometriosis.
Clinical value of early viscoelastometric point‐of‐care testing during postpartum hemorrhage for the prediction of severity of bleeding: A multicenter prospective cohort study in the Netherlands
Authors: Ramler Paul I. , Gillissen Ada , Henriquez Dacia D. C. A. , Caram‐Deelder Camila , Markovski Alexander A. , de Maat Moniek P. M. , Duvekot Johannes J. , Eikenboom Jeroen C. J. , Bloemenkamp Kitty W. M. , van Lith Jan M. M. , van den Akker Thomas , van der Bom Johanna G
Published: May 2021

Introduction

To evaluate rotational fibrin‐based thromboelastometry (ROTEM® FIBTEM) with amplitude of clot firmness at 5 min (A5) as an early point‐of‐care parameter for predicting progression to severe postpartum hemorrhage, and compare its predictive value with that of fibrinogen.

Material and methods

Prospective cohort study in the Netherlands including women with 800–1500 ml of blood loss within 24 h following birth. Blood loss was quantitatively measured by weighing blood‐soaked items and using a fluid collector bag in the operating room. Both FIBTEM A5 values and fibrinogen concentrations (Clauss method) were measured between 800 and 1500  ml of blood loss. Predictive accuracy of both biomarkers for the progression to severe postpartum hemorrhage was measured by area under the receiver operating curves (AUC). Severe postpartum hemorrhage was defined as a composite endpoint of (1) total blood loss >2000 ml, (2) transfusion of ≥4 packed cells, and/or (3) need for an invasive intervention to cease bleeding.

Results

Of the 391 women included, 72 (18%) developed severe postpartum hemorrhage. Median (IQR) volume of blood loss at blood sampling was 1100 ml (1000–1300) with a median (interquartile range [IQR]) fibrinogen concentration of 3.9 g/L (3.4–4.6) and FIBTEM A5 value of 17 mm (13–20). The AUC for progression to severe postpartum hemorrhage was 0.53 (95% confidence interval [CI] 0.46–0.61) for FIBTEM A5 and 0.58 (95% CI 0.50–0.65) for fibrinogen. Positive predictive values for progression to severe postpartum hemorrhage for FIBTEM A5 ≤12 mm was 22.5% (95% CI 14–33) and 50% (95% CI 25–75) for fibrinogen ≤2 g/L.

Conclusions

The predictive value of FIBTEM A5 compared to fibrinogen concentrations measured between 800 and 1500 ml of blood loss following childbirth was poor to discriminate between women with and without progression towards severe postpartum hemorrhage.
Epiretinal large disc of blue‐stained lyophilized amniotic membrane to treat complex macular holes: a 1‐year follow‐up
Authors: Garcin Thibaud , Gain Philippe , Thuret Gilles
Published: May 2021

Purpose

To report the long‐term outcomes of large diameter epiretinal lyophilized amniotic membranes (lAMs) in recurrent or persistent macular holes (MHs) with or without rhegmatogenous retinal detachment (RRD), in a prospective interventional case series.

Methods

Ten eyes of 10 patients underwent pars plana vitrectomy for MH‐associated RRD (n = 5) or persistent MH without RRD (n = 5), in a university Hospital. A 3 or 4 mm diameter disc of lAM, stained with 0.06% trypan blue, was inserted with a catheter through a sclerotomy and positioned over the MH. Gas or silicone‐oil tamponade was used. At 1 year, the main outcome was anatomic success defined as complete MH closure. Secondary outcomes were best corrected visual acuity (BCVA) recovery, changes in ellipsoid zone (EZ) and external limiting membrane (ELM) defects, complications. Mean follow‐up was 13.8 ± 2.9 months (range, 12–18).

Results

Mean baseline data were minimum and maximum diameters, respectively, 945 ± 330 and 1507 ± 717 μm; axial length 26.58 ± 3.38 mm; and number of prior surgeries 1.4 ± 0.96. At 1 year, anatomic success was achieved in eight eyes (80%), and two had reduced diameter of MH. All RRDs were reattached without recurrence. Mean logMAR BCVA improved from 1.92 ± 0.58 to 1.17 ± 0.57 (p < 0.001), with nine eyes (90%) achieving ≥0.3 logMAR improvement. Mean EZ and ELM defects decreased (p = 0.004, p = 0.003, respectively). Postoperative complications were RRD (n = 1) reattached by subsequent surgery, lAM slightly retracted under silicone (n = 1), foveal atrophy after early lAM displacement (n = 1).

Conclusion

A 1‐year follow‐up highlighted that epiretinal large discs of blue‐stained lAM can help safely close refractory MHs, and provide satisfactory visual recovery.
Inertia of negative emotions at work: Correlates of inflexible emotion dynamics in the workplace*
Authors: De Longis Evelina , Alessandri Guido , Sonnentag Sabine , Kuppens Peter
Published: May 2021

Emotional inertia is a central feature of emotion dynamics and it refers to the degree to which emotional states are self‐predictive and linger over time, describing their resistance to change. It is related to several indicators of maladjustment, yet there is limited research on its correlates in the workplace, where it may be particularly relevant as emotional experiences deeply influence organizational life. In two experience‐sampling studies, we studied temporal dependency of negative emotional states at work in terms of emotional inertia. In a first study (n = 128), we investigated the association between exhaustion, the core dimension of burnout, with inertia of negative emotions. In a second study (n = 116), we aimed to replicate findings from the first study and additionally examined the moderating role of inertia of negative emotions in the relationship between negative emotions at work and counterproductive work behaviour. The findings show that exhaustion is consistently associated with inertia of negative emotions, and that inertia of negative emotions aggravates the relation between negative emotions and workers' counterproductive work behaviour.
GATA zinc finger domain‐containing protein 2A (GATAD2A) deficiency reactivates fetal haemoglobin in patients with β‐thalassaemia through impaired formation of methyl‐binding domain protein 2 (MBD2)‐containing nucleosome remodelling and deacetylation (NuRD) complex
Authors: Liang Yunhao , Zhang Xinhua , Liu Yongqiong , Wang Liren , Ye Yuhua , Tan Xuemei , Pu Jiajie , Zhang Qianqian , Bao Xiuqin , Wei Xiaofeng , Li Dongzhi , Kurita Ryo , Nakamura Yukio , Li Dali , Xu Xiangmin
Published: May 2021

Reactivation of fetal haemoglobin (HbF) expression is an effective way to treat β‐thalassaemia and sickle cell anaemia. In the present study, we identified a novel GATA zinc finger domain‐containing protein 2A (GATAD2A) mutation, which contributed to the elevation of HbF and ameliorated clinical severity in a patient with β‐thalassaemia, by targeted next‐generation sequencing. Knockout of GATAD2A led to a significant induction of HbF in both human umbilical cord blood‐derived erythroid progenitor‐2 (HUDEP‐2) and human cluster of differentiation (CD)34+ cells with a detectable impact on erythroid differentiation. Furthermore, heterozygous knockout of GATAD2A impaired recruitment of chromodomain helicase DNA‐binding protein 4 (CHD4) to the methyl‐binding domain protein 2 (MBD2)‐containing nucleosome remodelling and deacetylation (NuRD) complex. Our present data suggest that mutations causing the haploinsufficiency of GATAD2A might contribute to amelioration of clinical severity in patients with β‐thalassaemia.
Um Compasso Para Aprender: A Randomized Trial of a Social‐Emotional Learning Program in Homicide‐Affected Communities in Brazil
Authors: McCoy Dana C. , Hanno Emily C. , Ponczek Vladimir , Pinto Cristine , Fonseca Gabriela , Marchi Natália
Published: May 2021

Despite global demand, the large‐scale effects of social‐emotional learning (SEL) programming in developing countries remain underexplored. Using a randomized control trial, this study examined the effectiveness of a school‐wide SEL intervention—Programa Compasso (PC)—among 3,018 sociodemographically diverse, Portuguese‐speaking children (Mage = 9.85 years) attending 90 public primary schools across Rio de Janeiro, Brazil in 2017. Average impacts of PC on children’s executive function, emotion knowledge, and behavior problems after one school year were null. Moderation analyses did, however, reveal evidence for positive impacts of PC on children’s labeling of emotional expressions and inhibitory control within low‐homicide communities (d = 0.15 SDs), and null effects on these same outcomes in high‐violence areas. Implementation and cultural considerations are discussed.
Sexual dysfunction and activity avoidance in female kidney transplant patients
Authors: Xiao Panpan , Liu Min , Cui Lina , Ding Siqing , Xie Jianfei , Cheng Andy SK
Published: May 2021

Sexual dysfunction is common after kidney transplantation and has an adverse effect on patients’ quality of life. This paper aims to evaluate the female sexual function, activity avoidance, and kidney function among a convenience sample of patients who had a kidney transplant. A cross‐sectional study was conducted that included 250 patients had undergone a kidney transplant procedure >3 months ago, from multiple transplant centers and answered a self‐reported sociodemographic questionnaire, the female version of the Arizona Sexual Experience Scale, and the Tampa Scale for Kinesiophobia‐13. A correlation was found between sexual function and activity avoidance (r = .361, p < .001, n = 250) as well as between activity avoidance and kidney function (r = .198, p = .012, n = 250). Less education, having no child, post‐transplant time for <36 months, and smoking (active and passive) were risk factors for female sexual dysfunction after kidney transplantation. The results suggest that physicians that the importance of recognize the relationship between fear of sexual activity and sexual function and that they should provide patients with more education and guidance on post‐transplant sexual behaviors.
Reproductive justice: Non‐interference or non‐domination?
Authors: Bhakuni Himani
Published: May 2021

The reproductive justice movement started by black women’s rights activists made its way into the academic literature as an intersectional approach to women’s reproductive autonomy. While there are many scholars who now employ the term ‘reproductive justice’ in their research, few have taken up the task of explaining what ‘justice’ entails in reproductive justice. In this paper I take up part of this work and attempt to clarify the relevant kind of freedom an adequate theory of reproductive justice would postulate. To do so, I compare two approaches to reproductive freedom: an approach based on freedom as non‐interference and an approach based on freedom as non‐domination. I then argue that the non‐domination approach better fits the ideals of the reproductive justice movement as set forth by its founders and should be treated as one of the necessary conditions in any non‐ideal account of reproductive justice. Towards the end, I single out epistemic non‐domination as crucial in shaping the narrative around reproductive justice.
Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
Authors: Bekkers Stijn , Pruijn Ineke M J , van der Burg Jan J W , van Hulst Karen , Kok Saskia E , Delsing Corinne P , Scheffer Arthur R T , van den Hoogen Frank J A
Published: May 2021

Aim

To compare the effect of bilateral submandibular duct ligation and botulinum neurotoxin A (BoNT‐A) on drooling severity and its impact on daily life and care in children and adolescents with moderate‐to‐severe drooling.

Method

This was a randomized, interventional, controlled trial in which 53 children and adolescents (31 males, 22 females, mean age 11y, range 8–22y, SD 2y 10mo) with cerebral palsy (58.5%) or other non‐progressive developmental disorders (41.5%) were randomized to BoNT‐A (n=26) or bilateral submandibular duct ligation (n=27). A parent questionnaire on the severity of drooling in specific positions and daily activities and the impact of drooling on daily life and care was filled out at baseline and 8 and 32 weeks posttreatment.

Results

Both BoNT‐A and bilateral submandibular duct ligation had a positive effect on daily care, damage to electronic equipment and/or furniture, social interactions, and self‐esteem. However, bilateral submandibular duct ligation had a significant greater and longer‐lasting short‐ (8wks) and medium‐term (32wks) effect on daily care, reducing damage to electronic devices, and improving social interactions and satisfaction with life in general.

Interpretation

This randomized controlled trial confirms reduced drooling by both BoNT‐A and bilateral submandibular duct ligation, but provides new evidence on improved well‐being through a reduction in drooling. Even though there is a greater risk of complications and morbidity after bilateral submandibular duct ligation, compared to BoNT‐A there was a significantly greater and longer‐lasting positive effect on most outcomes.

What this paper adds

Bilateral botulinum neurotoxin A (BoNT‐A) and submandibular duct ligation had a positive effect on the well‐being of individuals with moderate‐to‐severe drooling.

Bilateral submandibular duct ligation had a greater effect on the impact of drooling during daily care than BoNT‐A.

Bilateral submandibular duct ligation reduced damage to electronic devices and improved social interactions and satisfaction with life.
Diastolic function assessed with speckle tracking over a decade and its prognostic value: The Copenhagen City Heart Study
Authors: Skaarup Kristoffer Grundtvig , Lassen Mats Christian Højbjerg , Marott Jacob Louis , Biering‐Sørensen Sofie R. , Johansen Niklas Dyrby , Modin Daniel , Jørgensen Peter Godsk , Jensen Gorm Boje , Schnohr Peter , Prescott Eva , Søgaard Peter , Møgelvang Rasmus , Biering‐Sørensen Tor
Published: May 2021

Background

The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) may be a more accurate measure of LV filling pressure then ratio of early filling pressure to early tissue velocity. The aim of the study was to investigate the impact of age, sex, obesity, smoking, hypertension, hypercholesterolemia, diabetes, physical activity level, socioeconomic, and psychosocial status on E/e'sr over a decade. Additionally, the predictive value of ΔE/e'sr on future major adverse cardiovascular events (MACE) has never been explored.

Method

The study included 623 participants from the general population, who participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5). Examinations were median 10 years apart. MACE was the composite endpoint of heart failure, myocardial infarction, and all‐cause death.

Results

Follow‐up time was median 5.7 years, and 43 (7%) experienced MACE. Mean age was 51 ± 14 years, and 43% were male. Mean ΔE/e'sr was 2.1 ± 23.0 cm. After multivariable adjustment for demographic, clinical, and biochemistry variables, high age (stand. β‐coef. = .24, P < .001) and mean arterial blood pressure (MAP) (stand. β‐coef. = .17, P < .001) were significantly associated with an accelerated increase in E/e'sr In multivariable Cox regression, E/e'sr at CCHS5 and ΔE/e'sr were independent predictors of MACE (HR = 1.20, 95% CI [1.01; 1.42] per 10 cm increase for both). ΔE/e'sr did only provide incremental prognostic value to change in left atrial volume index of the conventional diastolic measurements.

Conclusion

In the general population, age and MAP were predictors of an accelerated increase in E/e'sr over a decade. E/e'sr at CCHS5 and ΔE/e'sr were independent predictors of future MACE.
State anxiety modulates the effect of emotion cues on visual temporal sensitivity in autism spectrum disorder
Authors: Chakrabarty Mrinmoy , Atsumi Takeshi , Kaneko Ayako , Fukatsu Reiko , Ide Masakazu
Published: May 2021

Atypical processing of stimulus inputs across a range of sensory modalities in autism spectrum disorder (ASD) is widely reported. Sensory processing is known to be influenced by bodily internal states such as physiological arousal and anxiety. As a sizeable proportion of ASD reportedly have co‐morbid anxiety disorders that are linked with dysregulated arousal, we investigated if face emotion arousal cues influenced visual sensory sensitivity (indexed by temporal resolution) in ASD (n = 20) compared to a matched group of typically developed individuals (TD, n = 21). We asked further if emotion‐cued changes in visual sensitivity were associated with individual differences in state and trait anxiety. Participants reported the laterality of the second of two consecutive Gaussian‐blob flashes in a visual temporal order judgment task (v‐TOJ), demanding higher‐level visual processing. The key manipulation was presenting a task‐irrelevant face emotion cue briefly at unexpected time points preceding the task‐relevant flashes. Disgust vs. Neutral emotion signals significantly enhanced the visual temporal resolution in ASD. Individual state‐anxiety scores showed a fair correlative trend with the emotion‐cued changes in temporal resolution (Disgust versus Neutral) in ASD but missed statistical significance. Both these effects were absent in TD. The results show that individual state‐anxiety levels likely modulate the effect of emotions on visual temporal sensitivity in ASD. The findings support a nuanced approach to understand the disparate sensory features in ASD, by factoring in the interplay of the individual reactivity to environmental affective information and the severity of anxiety.
Light stimulation during postnatal development is not determinant for glutamatergic neurotransmission from the retinohypothalamic tract to the suprachiasmatic nucleus in rats
Authors: Reyes‐Mendez Miriam E. , Herrera‐Zamora J. Manuel , Osuna‐López Fernando , Navarro‐Polanco Ricardo A. , Mendoza‐Muñoz Néstor , Góngora‐Alfaro José L. , Moreno‐Galindo Eloy G. , Alamilla Javier
Published: May 2021

The hypothalamic suprachiasmatic nucleus (SCN) is the leading circadian pacemaker in mammals, which synchronizes with environmental light through the retinohypothalamic tract (RHT). Although the SCN regulates circadian rhythms before birth, postnatal synaptic changes are needed for the RHT‐SCN pathway to achieve total functional development. However, it is unknown whether visual experience affects developmental maturation. Here, we studied the effects of constant darkness (DD) rearing on the physiology (at pre‐ and postsynaptic levels) of glutamatergic neurotransmission between RHT and SCN during postnatal development in rats. Upon recording spontaneous and evoked excitatory postsynaptic currents (EPSCs) by electrical stimulation of RHT fibers, we found that DD animals at early postnatal ages (P3–19) exhibited different frequencies of spontaneous EPSCs and lower synaptic performance (short‐term depression, release sites, and recruitment of RHT fibers) when compared with their normal light/dark (LD) counterparts. At the oldest age evaluated (P30–35), there was a synaptic response strengthening (probability of release, vesicular re‐filling rate, and reduced synaptic depression) in DD rats, which functionally equaled (or surmounted) that of LD animals. Control experiments evaluating EPSCs in ventral SCN neurons of LD rats during day and night revealed no significant differences in spontaneous or evoked EPSCs by high‐frequency trains in the RHT at any postnatal age. Our results suggest that DD conditions induce a compensatory mechanism in the glutamatergic signaling of the circadian system to increase the chances of synchronization to light at adult ages, and that the synaptic properties of RHT terminals during postnatal development are not critically influenced by environmental light.
Habitat determines the relationships among bacteria, resistance genes and mobile genetic elements in the soil–plant system
Authors: Huang Ruilin , Ding Jixian , Guo Yuwei , Sun Bo , Liang Yuting
Published: May 2021

The soil antibiotic resistome is considered to be primarily determined by bacterial community composition. However, the antibiotic resistance of plant microbiota and its association with the soil microbiome in soil–plant systems remain largely unknown. Here, we studied the connections between bacteria and resistance genes (RGs) (mainly antibiotic resistance genes, ARGs) and mobile genetic elements (MGEs) in different cropping systems (rice monoculture, and ryegrass–rice and vetch–rice rotation), growth periods (early, tillering and harvesting stages) and habitats (the soil, rhizoplane and phyllosphere) through high‐throughput qPCR and 16S rRNA sequencing. The results showed that habitat was the major factor affecting the distribution of bacteria, RGs and MGEs, whereas the cropping system had less of an effect. The relative abundances of ARGs, multidrug resistance genes, metal resistance genes and integrons were highest in the soil and lowest in the phyllosphere, as was the α‐diversity of the soil and plant microbiota. Most importantly, we found that bacteria had the strongest associations with RGs and MGEs in the rhizoplane rather than in the soil and phyllosphere, which might be due to the high network interactions among rhizoplane bacteria. These results suggest that the rhizoplane could be a hotspot for exchange of ARGs in the soil–plant system.

Highlights

The distributions of bacteria, RGs and MGEs were primarily controlled by habitat.

The strongest associations were found between rhizoplane bacteria and RGs and MGEs.

Rhizoplane bacteria had the strongest network associations.
Case management systems and new routines in community organisations
Authors: Yigitbasioglu Ogan , Furneaux Craig , Rossi Sari
Published: May 2021

This multiple‐case study examines the adoption of a case management system (CMS) across two community organisations in Australia using organizational routines as a theoretical lens. Both the adopters and the vendor were interviewed to explore how the CMS was instituted in the adopting organisations. Many of the concerns or problems associated with a CMS as reported in the literature were not supported in this study. Although the two cases differed significantly in terms of size and resources, the findings show that the adoption of CMS led to new ostensive and performative routines around data collection and service delivery in both organisations. This had implications for accountability and organisational learning. In particular, better access to data improved visibility and reporting on the provision of services and subsequently supported fundraising. This study also highlights some of the situational factors that facilitate or impede the transition to a CMS such as the critical role of the CMS administrator and the way the change is managed in adopting organisations. Overall, this study contributes to the discourse on CMS by providing some evidence to support a more nuanced view of CMS including as ‘systems of accountability’ or even a ‘necessity’ of the digital age rather than merely as ‘instruments of neoliberal policy’ and enablers of bureaucratisation of social work.
Neurological consequences of neurovascular unit and brain vasculature damages: potential risks for pregnancy infections and COVID‐19‐babies
Authors: Rasile Marco , Lauranzano Eliana , Mirabella Filippo , Matteoli Michela
Published: May 2021

Intragravidic and perinatal infections, acting through either direct viral effect or immune‐mediated responses, are recognized causes of liability for neurodevelopmental disorders in the progeny. The large amounts of epidemiological data and the wealth of information deriving from animal models of gestational infections have contributed to delineate, in the last years, possible underpinning mechanisms for this phenomenon, including defects in neuronal migration, impaired spine and synaptic development, and altered activation of microglia. Recently, dysfunctions of the neurovascular unit and anomalies of the brain vasculature have unexpectedly emerged as potential causes at the origin of behavioral abnormalities and psychiatric disorders consequent to prenatal and perinatal infections. This review aims to discuss the up‐to‐date literature evidence pointing to the neurovascular unit and brain vasculature damages as the etiological mechanisms in neurodevelopmental syndromes. We focus on the inflammatory events consequent to intragravidic viral infections as well as on the direct viral effects as the potential primary triggers. These authors hope that a timely review of the literature will help to envision promising research directions, also relevant for the present and future COVID‐19 longitudinal studies.
Creep degradation assessment of a Super304H austenitic steel by using misorientation‐derived parameters (electron backscatter diffraction)
Authors: Wang Xiao , Zhang Yuetao , Chang Qing , Huang Mingyu
Published: May 2021

This paper reports the degradation assessment of Super304H during the creep by using misorientation‐derived parameters (EBSD). The results manifested that with increasing creep time, the change of misorientation parameters (i.e., Kernel Average Misorientation [KAM], grain reference orientation deviation [GROD], Grain Orientation Spread [GOS], and geometrically necessary dislocation [GND] density) of Super304H was significant. Meanwhile, the above parameters presented a non‐monotonic variation trend, which decreased slightly at first and then increased at the later. In addition, the increase amplitude of GROD and GOS was larger than the KAM and GND density, which manifest that the GROD and GOS are more suited to the creep degradation assessment of Super304H.
The riddle of the greywacke: a story of friendship and rivalry, failure and success
Authors: Davidson Nick
Published: May 2021

In the early 1800s, two of the greatest geologists of the nineteenth century set out to solve one of the big riddles of the age: the early history of the Earth. This is the story of the moment when one of the greatest scientific collaborations of Victorian Britain turned into a bitter and destructive rivalry that dominated the new science of geology for two decades.
The political is personal: Postfeminism and the construction of the ideal working mother
Authors: Delaney Helen , Sullivan Katie R.
Published: May 2021

This paper critically analyses how postfeminist discourse plays out in media constructions of politician New Zealand Prime Minister Jacinda Ardern becoming a mother while in office. Data for this project include Ardern's public announcements of her pregnancy, her daughter's birth, and responses to questions regarding being a working mother. Alongside Ardern's framing of becoming a working mother, we also analyze how mainstream media reported on and sought meaning around her story. We are guided by the questions: How do different feminisms materialize in Ardern's case and how do they help us make sense of working and mothering in postfeminist times? Our analysis contributes to gender and organizational literature by teasing out the tensions and possibilities that emerge for a feminist politics of mothering and working.
Mothering with a career during a pandemic; the case of the Ghanaian woman
Authors: Akuoko Philipa Birago , Aggrey Vincent , Mengba Jennifer Dokbila
Published: May 2021

The paper examines the multi‐tasked role of women in caregiving and career during the COVID‐19 partial lockdown in Ghana. One hundred fifty three mothers with careers within the Accra Metropolis participated in the study through purposive and snow balling sampling methods of non‐probability sampling technique. To observe the COVID‐19 protocols of social distancing, the research instrument was designed using Google forms and distributed to respondents via social media platforms (emails and WhatsApp). The results revealed that caregiving mothers generally reported to work late from home than if there were in the office and were less effective and productive working from home but were assured of job security because they mostly worked in the public sector. Hours used for domestic activities rose steadily during the lockdown period and social support from non‐relatives in caregiving increased. The paper’s finding suggests that mothers working from home are faced with difficult and conflicting roles which puts more pressure on women during the pandemic period. Women who are unable to access social support continue to be stressed and burdened in an attempt to combine family, care giving, and career roles which ultimately affect their overall wellbeing.
The politics of kitchen work: Co‐production of a retired man's “hegemonic masculinity” during the COVID‐19 quarantine
Authors: Han Yuchen
Published: May 2021

This article documents the reconstructed domestic masculinity of a retired Chinese man during the COVID‐19 quarantine period in China. It is based on participant observation of the man and his family as a case study. It demonstrates how the man turns kitchen work into a “masculine” job, and uses it as a contested terrain for constructing hegemonic masculinity by adopting scientific discourse explicitly and traditional patriarchal discourse implicitly. It also highlights women's conscious and deliberate interactions with the man in contributing to the making of hegemonic masculinity for the sake of their own values of happiness. The author seeks an understanding of the intersection of aging, patriarchal norms, and women's agency through the case of the co‐production of a retired man's hegemonic masculinity in the context of the COVID‐19 quarantine.
Approaching the history of an Egyptian biomedicine
Authors: Derr Jennifer L.
Published: May 2021

This piece explores the history of medicine in Egypt, the roots of an Egyptian practice of biomedicine in particular, through its historiography. In the period after World War II, the term “biomedicine” came to describe a practice of medicine defined by the close relations among clinicians, biological laboratory research, and the pharmaceutical industry in Europe and the United States. The history of medicine in Egypt and other parts of the Middle East and North Africa has long possessed close links to that in regions of Europe. In Egypt too, biomedicine has deep historical roots shaped by the influence of the nineteenth‐century Ottoman‐Egyptian state, the experience of colonialism, and the anti‐colonial objectives of the post‐colonial Egyptian state in the second half of the twentieth century. These influences were particularly important in relation to the treatment of schistosomiasis, one of Egypt's top‐ranking health problems of the twentieth century. The history of schistosomiasis demonstrates the gaps in the historiography of medicine in modern Egypt as well as how we might begin to consider the emergence of biomedical knowledge and theory at sites in Global South.