Late Exposure Research Articles

Coste efectividad de la estrategia de cribado de citomegalovirus en recién nacidos mayores de 34 semanas de bajo peso para la edad gestacional

IntroductionInfection by cytomegalovirus (CMV) is one of the most common congenital infections, with a global prevalence of 0.3%-2.4%. In Spain, CMV screening is not performed during pregnancy, but rather in neonates with risk factors, and, in many hospitals, in those born small for gestational age (SGA). Screening is usually performed by measurement of the viral load in urine by polymerase chain reaction (PCR) and/or head ultrasound in search of compatible features.The aim of the study was to assess the yield of the CMV PCR test in urine and head ultrasound examination in asymptomatic neonates born SGA after 34 weeks’ gestation. The secondary objective was to assess the cost-effectiveness of this strategy. Design and methodsWe conducted an observational and retrospective study between January and December 2019 in a tertiary care hospital. It included neonates delivered after 34 weeks, SGA and without additional risk factors assessed with a CMV PCR test in urine and/or head ultrasound. ResultsThe sample included 259 patients. It was divided in two groups: group 1, patients with a head circumference, weight and length below the 10th percentile (53 patients; 20.5%), and group 2, patients in whom only the weight was below the 10th percentile (206 patients; 79.5%). The incidence of late preterm birth, twin pregnancy, neonatal admission and exposure to illicit drugs during gestation was higher in group 1. A total of 186 urine PCR tests and 223 head ultrasounds were performed overall, and both tests were performed more frequently in group 1 (P=.002). There was only one positive CMV PCR test result in the sample (0.54%), corresponding to a patient in group 2 with no abnormal sonographic findings who remained asymptomatic throughout the followup. Two head ultrasound examinations yielded abnormal findings, in both cases unrelated to congenital CMV infection. We performed a cost-effectiveness analysis and determined that the cumulative cost of head ultrasound examinations and urine CMV PCR tests in our sample amounted to €17000 for the detection of a single asymptomatic positive case. ConclusionIn our population, screening for congenital CMV infection in asymptomatic late preterm and term newborns whose only risk factor is SGA does not seem to be cost effective. It would be necessary to expand the sample to other populations.

Learning to introduce referents in narration is resilient to the effects of late sign language exposure

Abstract The present study investigates the effects of late sign language exposure on narrative development in Turkish Sign Language (TİD) by focusing on the introductions of main characters and the linguistic strategies used in these introductions. We study these domains by comparing narrations produced by native and late signers in TİD. The results of our study reveal that late sign language exposure does not hinder the acquisition of linguistic devices to introduce main characters in narrations. Thus, their acquisition seems to be resilient to the effects of late language exposure. Our study further suggests that a two-year exposure to sign language facilitates the acquisition of these skills in signing children even in the case of late language exposure, thus providing further support for the importance of sign language exposure to develop linguistic skills for signing children.

Duloxetine Exposure During Pregnancyand the Risk of Offspring Being Born Small for Gestational Age or Prematurely: A Nationwide Danish and Swedish Safety Study.

Depression or depressive symptoms are common among pregnant women. The use of antidepressants during pregnancy has grown steadily. The risk of offspring being born small for gestational age or prematurely when exposed to duloxetine during pregnancy is not established. We aimed to investigate the association between duloxetine exposure during pregnancy and offspring being born small for gestational age or prematurely. We conducted an observational study including live births in Sweden and Denmark (2004-2016). Duloxetine exposure during early (0-140 days) or late (141 to delivery) pregnancy compared with duloxetine-non-exposed, selective serotonin reuptake inhibitor-exposed, venlafaxine-exposed, and duloxetine discontinuers. In total, 2,083,467 pregnancies were identified, where 1589 and 450 were duloxetine exposed in early and late pregnancy, respectively. For small for gestational age, no increased risk was seen for duloxetine across comparators. In the early and late exposure windows, propensity score-matched odds ratios for small for gestational age ranged between 0.64 (95% confidence interval 0.44-0.95) and 1.48 (95% confidence interval 0.85-2.57). For preterm birth, the findings differed across comparators and exposure-time windows, but trended towards an increased risk for duloxetine-exposed when compared with duloxetine-non-exposed, selective serotonin reuptake inhibitor-exposed, and duloxetine discontinuers in both early exposure and late exposure. The odds ratios ranged between 1.17 and 2.04, of which some did not reach statistical significance. No clear association was observed when compared with venlafaxine exposed, 0.91 (95% confidence interval 0.73-1.14) for early exposure and 1.26 (95% confidence interval 0.86-1.86) for late exposure. Most preterm births (79.2%) occurred in weeks 33-36 of gestation. Duloxetine exposure during pregnancy is unlikely to increase the risk of small for gestational age. Although not consequently statistically significant across comparisons, a trend towards an increased risk of preterm birth was observed for duloxetine exposed. Therefore, an increased risk of preterm birth cannot be excluded, especially for women exposed to duloxetine throughout pregnancy.

THE EFFECT OF STATIC MAGNETIC FIELD EXPOSURE ON BODY WEIGHT AND ADIPOSE CELLS DENSITY OF OBESE MICE

Obesity is a mojar public health problem in worldwide, especially in Indonesia. Obesity in addition to affecting productivity, is also trigger for other chronic disease such as diabetes and cardiac disease. Body mass index is an assessment tool used to assess degree of individual adiposity to define overweight, obesity, and severe obesity.The determination of obesity is based on the calculation of Body Mass Index (BMI), which devide body weight (kg) by height (cm2). In addition to the method of regulating diet, exercise, and bariatric surgery for weight loss, it was reported that the biophysical therapy tool, that is static magnetic field (SMF) became a modality for weight loss. Based on research reports, it proves that the static magnetic field affects weight loss in the group of obese mice after 30 days of exposure. Therefore, in this study, we carried out static magnetic field exposure to obese mice with a field intensity of 2 mT for 1 hour/day. Mice were exposed gradually to SMF on 2, 7, 14, and 21 days to determine the effectiveness of SMF to obesity in mice in terms of weight loss and cellular adipose cell density. The results showed that the weight of mice decreased significantly on 2nd and 7th days of exposure, the trend showed a decrease in body weight until the 14th day. The density of adipose tissue is increased after exposure to SMF on the 14th and 21st days of exposure. It showed that early exposure to SMF (2 and 7 days) could induce weight loss in mice, while cellularly SMF increased adipose cell density on late exposure (14 and 21 days).

The role of exposure window and dose in determining lead toxicity in developing Zebrafish

Heavy metal contamination is recognized worldwide as a serious threat to human health and wildlife, and reducing their emissions is a priority of international and EU actions. Due to its persistence, high bioaccumulation tendency, and toxicity properties, lead (Pb) is one of the heavy metals of greatest concern. Even at low concentrations, lead induces various clinical and subclinical conditions in both humans and animals, and it has been included in the priority list of hazardous substances. In the present study, we used zebrafish's early stages as a model, given their well-acknowledged predictive value in the risk assessment of chemicals. This study was designed to investigate the morphological and morphometric alterations induced by Pb during zebrafish's early development and disclose the putative effects stage- and/or dose-dependent. We examined injuries induced by two environmentally relevant and extremely low concentrations of Pb (2.5 μg/L and 5 μg/L) during two exposure windows: early (between 1 and 7 dpf) and late (between 2 and 8 dpf). We clearly demonstrated that the incidence and severity of morphological abnormalities increased with increasing Pb dose and exposure time in both early and late-exposed groups. Furthermore, we revealed that malformation severity was significantly higher in the early exposed group than in the late exposure group at all exposure times and for both tested doses, thus highlighting the high sensitivity of zebrafish during the initial stages of development. The information presented in this paper emphasizes the effectiveness of morphological biomarkers in unveiling threatening situations and supports the role of zebrafish embryos and larvae in risk assessment and environmental monitoring.

Borrelia burgdorferi modulates the physical forces and immunity signaling in endothelial cells

SummaryBorrelia burgdorferi (Bb), a vector-borne bacterial pathogen and the causative agent of Lyme disease, can spread to distant tissues in the human host by traveling in and through monolayers of endothelial cells (ECs) lining the vasculature. To examine whether Bb alters the physical forces of ECs to promote its dissemination, we exposed ECs to Bb and observed a sharp and transient increase in EC traction and intercellular forces, followed by a prolonged decrease in EC motility and physical forces. All variables returned to baseline at 24 h after exposure. RNA sequencing analysis revealed an upregulation of innate immune signaling pathways during early but not late Bb exposure. Exposure of ECs to heat-inactivated Bb recapitulated only the early weakening of EC mechanotransduction. The differential responses to live versus heat-inactivated Bb indicate a tight interplay between innate immune signaling and physical forces in host ECs and suggest their active modulation by Bb.

Association between Early Life Famine Exposure and Metabolic Syndrome in Adulthood.

To analyze the relationship between famine exposure at different stages of early life and the risk of developing metabolic syndrome (MetS) in adulthood, 11,865 study participants from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance Program were enrolled and then divided into a non-exposed group, fetal exposure group, early childhood exposure group, middle childhood exposure group and late childhood exposure group according to their birth time and famine exposure. MetS was defined by the NCEP ATP III criteria. Using logistic regression to explore the association between famine exposure at different stages of early life and the increased risk of developing MetS in adulthood. After adjusting other factors, compared with the non-exposure group, famine exposure during the fetal period (OR = 1.23, 95% CI = 1.00–1.51), early childhood (OR = 1.44, 95% CI = 1.11–1.87), middle childhood (OR = 1.50, 95% CI = 1.13–1.99) and late childhood (OR = 1.67, 95% CI = 1.21–2.30) had a higher risk of developing MetS in adulthood. Stratified analysis found an association between early life famine exposure and the increased risk of MetS in adulthood in females, overweight or obese participants and those who lived in areas of severe famine, in city areas and in southern China. Compared with the non-exposed group, the fetal, early childhood, middle childhood and late childhood famine-exposed groups are more likely to suffer from MetS in adulthood, especially the subjects who are females, overweight or obese and had lived in severe famine areas, city areas and southern China.

Early life exposure to the Chinese Famine of 1959-1961 is an independent risk factor of adulthood elevated homocysteine, hyperuricemia, high LDL, and hypertension.

Famine exposure in early life was associated with cardiovascular diseases in later life. Whether biochemical surrogates of cardiovascular diseases, such as homocysteine and uric acid, are also associated with famine exposure is unknown so far. Data were derived from a population-based cross-sectional study in the Hunan Province of China, which was heavily affected by the Famine in 1959-1961. A total of 1,150 adults born between 1952and1964 were selected, and 5 cohorts were defined: no exposure, fetal, early childhood, mid-childhood, and late childhood exposure. Compared with the no-famine exposure group, participants exposed to famine in their fetal period had a higher risk of high homocysteine in adulthood with OR of 2.21 (95% CI: 1.01-4.83), whereas famine exposures in early, mid, or late childhood were not significantly associated with high homocysteine in adulthood. Similarly, participants in the fetal famine exposure group had a 1.59-fold higher risk of hyperuricemia (OR = 2.59, 95% CI: 1.07-5.30) and a 2.03-fold higher risk of high low-density lipoprotein cholesterol (LDL) (OR = 0.03, 95% CI: 1.35-6.78) in adulthood compared to those without famine exposure, respectively. We furthermore conducted a meta-analysis including 16 studies regarding the association between fetal famine exposure and adulthood hypertension, including our study. The meta-analysis, including 34,804, subjects showed that fetal famine exposure is associated with a higher risk of adulthood hypertension (OR=1.22, 95% CI: 1.07-1.40). Taken together, fetal famine exposure is related to higher odds of cardio-metabolic risk factors, such as high homocysteine, hyperuricemia, and LDL as well as hypertension, suggesting that undernutrition during fetal life may affect metabolism of homocysteine, uric acid, and LDL in adulthood.

New sedimentary constraints for the Late Devonian north-dipping Paleo-Tethys subduction and its eastern continuation on Hainan Island, South China

As a major boundary between the Simao-Indochina and South China blocks, the Jinshajiang–Ailaoshan–Song Ma suture zone preserves the remnants of a back-arc basin or a branch of the Paleo-Tethys Ocean. However, whether this suture zone extends eastward to the Hainan Island is still controversial. Here, we use detrital zircon U–Pb geochronology to explore the source-to-sink characteristics of the Lower Carboniferous-Lower Permian strata in Hainan Island and mainland southeast China (SE China). The results, combined with published data for the Devonian-Triassic sandstones from Hainan and SE China, show that the Devonian-Lower Permian samples display similar detrital zircon age populations at ∼430 Ma, ∼930–980 Ma, ∼1600–1800 Ma and ∼2400 Ma. However, the Upper Permian-Triassic sandstones have a predominant zircon population at ∼370 Ma, indicating a dramatic change in the detritus provenance for Hainan-SE China since the early Late Permian. The presence of similar 400-350 Ma detrital zircons peaked at ∼370 Ma with ϵHf(t) values from −12 to +3 in the sedimentary rocks from both Hainan-SE China and Simao-Indochina blocks indicates that these two terranes should have a similar detritus source with abundant Late Devonian magmatic rock exposure during the Late Permian-Triassic. These Late Devonian magmatic rocks were most likely formed by the north-dipping Paleotethyan subduction. This conclusion is consistent with the recent discovery of Upper Devonian arc-related tuffs, volcaniclastics, tuffaceous chert and rhyolite in the North Qiangtang, Simao-Indochina and East Malaya terranes, and possibly also in the southern Hainan. These Upper Devonian rocks could have acted as detritus source for the basins in SE China-Hainan, as well as the Youjiang Basin in SW China, after the collision between the Indochina and South China blocks. Combined with the transition from a carbonate platform to clastic facies in the early Late Permian in SE China, the Indochina-South China collision on Hainan Island may have occurred at ∼266-260 Ma, earlier than that (∼250-230 Ma) along the Jinshajiang–Ailaoshan–Song Ma suture zone. Such a temporal–spatial source-to-sink relationship between the Late Devonian arc and basins on the southern margin of South China suggests that SE China-Hainan should be located within the Paleo-Tethys rather than the Paleo-Pacific tectonic domain during the Early Carboniferous-early Late Permian.

A fossil assemblage from the mid-late Maastrichtian of Gavdos Island, Greece, provides insights into the pre-extinction pelagic ichthyofaunas of the Tethys.

The global body-fossil record of marine 'fishes' from the time interval immediately preceding the Cretaceous-Paleogene Extinction is markedly poor. This deficiency appears to be further exacerbated with regards to offshore and deep-water taxa, obscuring our understanding of the state and composition of corresponding vertebrate faunas at the onset of this major extinction event. Recent fieldwork in the mid-late Maastrichtian exposures of the Pindos Unit in Gavdos Island, Greece, yielded a small but informative sample of fossil 'fishes', which inhabited the Tethys approximately three to four million years before the extinction. In this work we describe this sample, which comprises between eight and nine discrete morphotypes of various size classes, belonging to †Ichthyodectoidei, Aulopiformes (†Dercetidae, †Enchodontidae, †Ichthyotringidae), cf. †Sardinioididae, as well as the hexanchid shark †Gladioserratus sp. The new material expands the faunal list for the Maastrichtian of Gavdos Island, and the Pindos Unit as a whole, and further allows for the description of a new genus and species of †Enchodontidae and a new species of †Ichthyotringidae. The two new taxa are found to be widespread in the Maastrichtian of the Pindos Unit. The overall character of the assemblage agrees with previous interpretations of an offshore and rather deep depositional environment for the fossiliferous horizons. Furthermore, it exhibits a higher diversity than, and little taxonomic overlap with penecontemporaneous teleost assemblages from the Tethys, and informs on the otherwise poorly known Maastrichtian offshore and deep-water marine ichthyofaunas of the region.

Guided bone regeneration using titanium mesh to augment 3-dimensional alveolar defects prior to implant placement. Apilot study.

ObjectivesTo evaluate the outcomes of bone regeneration using a customized titanium mesh scaffold to cover a bone graft for reconstruction of complex defects of the jaws.Materials and Methods19 large defects were digitally reconstructed using CT scans according to the prosthetic requirements. A titanium mesh scaffold was designed to cover the bone (autologous/bovine bone particulate) graft. At least 6 months after surgery, a new cone‐beam CT was taken. The pre‐ and postoperative CT datasets were then converted into three‐dimensional models and digitally aligned. The actual mesh position was compared to the virtual position to assess the reliability of the digital project. The reconstructed bone volumes (RBVs) were calculated according to the planned bone volumes (PBVs), outlining the areas under the mesh. These values were then correlated with the number of exposures, locations of atrophy, and virtually planned bone volume.ResultsThe mean matching value between the planned position of the mesh and the actual one was 82 ± 13.4%. 52.3% (40% early and 60% late) exposures were observed, with 15.8% exhibiting infection. 26.3% resulted as failures. The amount of reconstructed bone volume (RBV) in respect to PBV was 65 ± 40.5%, including failures, and 88.2 ± 8.32% without considering the failures. The results of the exposure event were statistically significant (p = .006) in conditioning the bone volume regenerated.ConclusionsThis study obtained up to 88% of bone regeneration in 74% of the cases. The failures encountered (26%) should underline the operator's expertise relevance in conditioning the final result.

Late sign language exposure does not modulate the relation between spatial language and spatial memory in deaf children and adults

Prior work with hearing children acquiring a spoken language as their first language shows that spatial language and cognition are related systems and spatial language use predicts spatial memory. Here, we further investigate the extent of this relationship in signing deaf children and adults and ask if late sign language exposure, as well as the frequency and the type of spatial language use that might be affected by late exposure, modulate subsequent memory for spatial relations. To do so, we compared spatial language and memory of 8-year-old late-signing children (after 2 years of exposure to a sign language at the school for the deaf) and late-signing adults to their native-signing counterparts. We elicited picture descriptions of Left-Right relations in Turkish Sign Language (Türk İşaret Dili) and measured the subsequent recognition memory accuracy of the described pictures. Results showed that late-signing adults and children were similar to their native-signing counterparts in how often they encoded the spatial relation. However, late-signing adults but not children differed from their native-signing counterparts in the type of spatial language they used. However, neither late sign language exposure nor the frequency and type of spatial language use modulated spatial memory accuracy. Therefore, even though late language exposure seems to influence the type of spatial language use, this does not predict subsequent memory for spatial relations. We discuss the implications of these findings based on the theories concerning the correspondence between spatial language and cognition as related or rather independent systems.

Differential effects of early or late exposure to prenatal maternal immune activation on mouse embryonic neurodevelopment

Exposure to maternal immune activation (MIA) in utero is a risk factor for neurodevelopmental and psychiatric disorders. MIA-induced deficits in adolescent and adult offspring have been well characterized; however, less is known about the effects of MIA exposure on embryo development. To address this gap, we performed high-resolution ex vivo MRI to investigate the effects of early (gestational day [GD]9) and late (GD17) MIA exposure on embryo (GD18) brain structure. We identify striking neuroanatomical changes in the embryo brain, particularly in the late-exposed offspring. We further examined the putative neuroanatomical underpinnings of MIA timing in the hippocampus using electron microscopy and identified differential effects due to MIA timing. An increase in apoptotic cell density was observed in the GD9-exposed offspring, while an increase in the density of neurons and glia with ultrastructural features reflective of increased neuroinflammation and oxidative stress was observed in GD17-exposed offspring, particularly in females. Overall, our findings integrate imaging techniques across different scales to identify differential impact of MIA timing on the earliest stages of neurodevelopment.

Rat Model of Late Gestational Alcohol Exposure Produces Similar Life-Long Changes in Thalamic Nucleus Reuniens Following Moderate- Versus High-Dose Insult.

Recent studies have recognized that thalamic nucleus reuniens (Re) undergoes substantial neuron loss following alcohol exposure (AE) during the brain growth spurt (BGS). As all previous studies have utilized high-dose AE paradigms, we tested whether moderate-dose AE is capable of damaging Re to a similar degree as high-dose AE. We used a rat model of third-trimester binge AE (relative to human pregnancy) to administer ethanol to rat pups at either a high (5.25g/kg/day) or moderate (3.00g/kg/day) dose during the BGS (postnatal days [PD] 4-9) via intragastric intubation. In adulthood (i.e. PD72), we quantified the volume of Re as well as the total number of neurons and non-neuronal cells in the nucleus (which were further divided into microglia versus 'other' non-neurons), using unbiased stereological estimation of cells identified with immunofluorescent markers (i.e. nuclear label Hoechst, neuron-specific protein NeuN, and microglia-specific protein Iba1). Data were analyzed both between-treatment and correlated with peak blood alcohol concentration (BAC). We observed significant neuronal and non-neuronal cell loss in both the high-dose and moderate-dose AE groups (relative to both procedural control and typically-developing control groups), which mediated reductions in Re volume. Outcomes did not correlate with peak BAC, further supporting that Re is vulnerable to AE-induced neurodegeneration at lower doses than previously suspected. Given the role that Re has in coordinating prefrontal cortex and hippocampus, the current study highlights the role that thalamic damage may play in the range of behavioral alterations observed in Fetal Alcohol Spectrum Disorders.

Association Between Type 1 Diabetes Mellitus and Celiac Disease: Autoimmune Disorders With a Shared Genetic Background

Type 1 diabetes mellitus (T1DM) and celiac disease (CD) are one of the most recognized related autoimmune disorders as they share a common genetic background that has been found in the HLA genotype, more specifically DQ2 and DQ8 molecules. Studies have shown that environmental factors as early or late exposure to cereals in the first months of life or the acquired viral infections have been implicated in the risk of development of autoantigens. CD, in most cases, is asymptomatic; therefore, it goes underdiagnosed. As a result, it has been linked to late consequences as decreased growth, delayed puberty, and anemia. Also, CD has been considered an independent risk factor for nephropathy and retinopathy. Therefore, in T1DM patients, as high-risk individuals, a CD screening has been recommended, especially to analyze their joint management. A gluten-free diet has been studied and linked to possible benefits in glycemic control or decreasing the hypoglycemic episodes in T1DM and preventing in CD the late bowel mucosal damage as gluten has been well documented as the primary trigger of these autoimmune responses. This article has reviewed the concurrent occurrence of T1DM and CD regarding the pathogenesis, clinical overlaps, screening, and management options.

Evidence of Glacial Erratic Rollover Revealed by 10Be and 26Al Concentration Variations

AbstractCosmogenic nuclide exposure dating is one of the most intensively applied dating methods with which to study glacial geomorphology. Glacial erratics have been the major dating objective in many studies. Some research has proposed that glacial erratics may undergo rollover and re‐transportation during the late exposure stage, which can affect the dating results. However, there is no direct evidence to confirm this possibility. In this study, we collected seven samples from a vertical section inside a glacial erratic in the paleo‐Daocheng ice cap in the southeastern Tibetan Plateau, measuring their contents of the cosmogenic nuclides 10Be and 26Al. The results show that from the top to the bottom, the concentrations of 10Be were (1.21 ± 0.05) × 106, (1.00 ± 0.02) × 106, (0.88 ± 0.03) × 106, (0.77 ± 0.02) × 106, (0.75 ± 0.03) × 106, (0.95 ± 0.03) × 106 and (1.46 ± 0.04) × 106 atoms/g. The 10Be concentrations decreased from (1.21 ± 0.05) × 106 atoms/g to (0.75 ± 0.03) × 106 atoms/g and then increased to (1.46 ± 0.04) × 106 atoms/g, which is not consistent with the theoretical prediction of a gradual decrease. This phenomenon indicates that the glacial erratic may have rolled over at least once. The lower surface of the erratic could have been on top at some time in the past. Therefore, its exposure age was greater than the exposure age that was expected, based on its current orientation. This study provides numerical evidence for an erratic rollover event.

EBNEO Commentary: Paracetamol/acetaminophen to avoid PDA ligation: How to interpret impact on 18- to 24-month outcomes.

Mashally S, Banihani R, Jasani B, Nield LE, Martins FF, Jain A, Weisz DE. Is late treatment with acetaminophen safe and effective in avoiding surgical ligation among extremely preterm neonates with persistent patent ductus arteriosus? J Perinatol 2021; Aug 21; 1–7. Online ahead of print. PMID 34453113. Acetaminophen (APAP) use among ELBW infants is increasing worldwide.1, 2 There is an urgent need to evaluate both the safety and efficacy of APAP for PDA treatment. In this retrospective study, Mashally and colleagues have compared outcomes of ELGANS in which differing approaches across two epochs were used for the treatment of a persistent PDA (pPDA) at a single centre: surgical ligation and APAP with ligation after failed closure. Comparing the neurodevelopmental outcomes of these infants at 18–24 months corrected age, the authors found no difference in the risk of NDI or death between infants treated for a pPDA between the two epochs. They conclude that APAP is a safe and effective therapy for late treatment of the PDA to avoid surgical ligation. These results add to the growing body of literature evaluating the use of APAP for PDA treatment. However, a number of issues must be considered. Although the authors state that the objective was to evaluate the ‘association of late treatment with acetaminophen vs. immediate surgical ligation with death or neurodevelopmental impairment (NDI) among extremely low gestational age neonates (ELGANs) with persistent patent ductus arteriosus (pPDA)’, this precise goal could not be met with the retrospective design and included subjects. Specifically, in epoch1 – the PDA ligation epoch – over 25% of the subjects did not undergo PDA ligation. In epoch2 – the APAP epoch – 20% were not exposed to APAP. Therefore, it is more accurate to state that this study compared outcomes across epochs with different prevailing clinical approaches to treatment of a late PDA. Furthermore, the small sample size also limits the ability to detect clinically relevant differences in outcomes. Larger observational and interventional studies that balance patient characteristics, avoid treatment contamination and minimise treatment selection bias are needed to determine the safety of APAP for pPDA. Lastly, any conclusion regarding the ‘safety’ of APAP must be considered in relation to the comparison therapy. In this study, the comparison was surgical ligation, which is an independent risk factor for poor neurodevelopmental outcomes.3 Given the risks of ligation, it could be argued that a pharmacologic approach that limits these exposures, and yet is not clearly safer, may potentially carry underappreciated risks that must be considered. The authors previously reported that late APAP exposure was associated with an increase in chronic lung disease.4 Although referenced in their methods, they do not comment further on this association here. The present report indicates that rates of moderate-severe bronchopulmonary dysplasia were 65% in epoch1 and 81% in epoch2 (p = 0.11). Although this difference did not reach statistical significance, a 16% absolute increase in the rates of this outcome is of possible clinical significance, particularly in the light of the reduced frequency of PDA ligation. This potential signal for harm, as well as the potential impact of APAP exposures on the developing lung, brain and endocrine function, reminds us that studies evaluating APAP safety should include broad measures of end-organ injury.5-7 With these points in mind, the conclusion regarding the safety of APAP should be regarded cautiously. URL LINK: URL TO THE FULL REVIEW ON THE EBNEO WEBSITE https://ebneo.org/apap-pda-ligation-18-24-month-outcomes None stated.

User perceptions of a range-based thermostat

In a vicious cycle, the rise of global temperatures increases demand for cooler indoor temperatures, while increased use of air conditioning leads to warmer outdoor temperatures. Most modern indoor-climate control systems aim to maintain thermal neutrality i.e., a near-constant indoor temperature, over entire spaces, if not also over time. This consumes significant resources while causing thermal discomfort for some indoor occupants. In an online study, this work explored user perceptions towards dynamic indoor temperatures, which can lead to significant resource conservation. The study included two conditions, early versus late exposure to a range-based thermostat, to assess its user acceptance, in the context of study participants’ 1) summer temperatures, 2) general temperature preferences and habits, 3) temperature-unit preference, and 4) extra-thermal factors. Due to local COVID-19 restrictions on in-person research, initial results will report on users’ behavioral intention.

Early-life exposure to famine and the risk of general and abdominal obesity in adulthood: a 22-year cohort study

ObjectivesThe aim of this study was to investigate how early-life exposure to famine affected the development of overweight, general obesity and abdominal obesity in Chinese adults. Study designThis study was a 22-year cohort study. MethodsData were derived from the China Health and Nutrition Survey, which is a national prospective cohort study. All participants born between 1949 and 1966 were potentially eligible. Height, weight and waist circumference (WC) were measured by trained healthcare workers. Height and weight were used to calculate body mass index, which was used to define general obesity and WC was used to define abdominal obesity. Exposure to famine was defined using the birth date as follows: no exposure (participants born between 1962 and 1966); fetal exposure (participants born between 1959 and 1961); early childhood exposure (participants born between 1956 and 1958); mid-childhood exposure (participants born between 1953 and 1955); and late childhood exposure (participants born between 1949 and 1952). ResultsIn total, 6957 participants were included in this study. Results indicate that exposure to famine was linked to a lower risk of being overweight. Exposure to famine in mid-childhood decreased the risk of general obesity in both males (hazard ratio [HR] 0.485, 95% confidence interval [CI] 0.292–0.807 [P = 0.005]) and females (HR 0.426, 95% CI 0.256–0.709 [P = 0.001]). Exposure to famine during any period of childhood decreased the risk of abdominal obesity (P < 0.001). ConclusionsExposure to famine in early childhood decreased the risk of overweight and abdominal obesity in adulthood; however, exposure to famine only had a weak role in the development of general obesity.

The impact of exposure timing on embryo mortality and the partitioning of PAHs when cod eggs are exposed to dispersed and dissolved crude oil

During sub-sea oil spills to the marine environment, oil droplets will rise towards the sea surface at a rate determined by their density and diameter as well as the vertical turbulence in the water. Micro-droplets (< 50 µm) are expected to have prolonged residence times in the water column. If present, pelagic fish eggs may thus be exposed to dispersed oil from subsurface oil spills for days, and the contribution of these micro-droplets to toxicity is not well known. The purpose of this work was to investigate to what extent timing of exposure and the presence of oil micro droplets affects PAH uptake and survival of pelagic Atlantic cod eggs. A single batch of eggs was separated in two groups and exposed to dispersions and corresponding water-soluble fraction at 3–7 days (Early exposure) and 9–13 days (Late exposure) post fertilization. Partitioning of PAHs between crude oil microdroplets, water and eggs was estimated as well as the contribution of oil droplets to PAH body residue and acute and delayed mortality. Timing of oil exposure clearly affects both the mortality rate and the timing of mortality. Even though the body residue of PAHs were lower when embryos were exposed in the later embryonic stage, mortality rate increased relative to the early exposure indicating that critical body residue threshold is stage specific. Although our results suggest that the dissolved fraction is the dominating driver for toxicity in cod embryos exposed to oil dispersions, crude oil micro droplets contribute to increased mortality as well.