The evolution of parasitism from mutualism in wasps pollinating the fig, Ficus microcarpa, in Yunnan Province, China.

Theory identifies factors that can undermine the evolutionary stability of mutualisms. However, theory's relevance to mutualism stability in nature is controversial. Detailed comparative studies of parasitic species that are embedded within otherwise mutualistic taxa (e.g., fig pollinator wasps) can identify factors that potentially promote or undermine mutualism stability. We describe results from behavioral, morphological, phylogenetic, and experimental studies of two functionally distinct, but closely related, Eupristina wasp species associated with the monoecious host fig, Ficus microcarpa, in Yunnan Province, China. One (Eupristina verticillata) is a competent pollinator exhibiting morphologies and behaviors consistent with observed seed production. The other (Eupristina sp.) lacks these traits, and dramatically reduces both female and male reproductive success of its host. Furthermore, observations and experiments indicate that individuals of this parasitic species exhibit greater relative fitness than the pollinators, in both indirect competition (individual wasps in separate fig inflorescences) and direct competition (wasps of both species within the same fig). Moreover, phylogenetic analyses suggest that these two Eupristina species are sister taxa. By the strictest definition, the nonpollinating species represents a "cheater" that has descended from a beneficial pollinating mutualist. In sharp contrast to all 15 existing studies of actively pollinated figs and their wasps, the local F. microcarpa exhibit no evidence for host sanctions that effectively reduce the relative fitness of wasps that do not pollinate. We suggest that the lack of sanctions in the local hosts promotes the loss of specialized morphologies and behaviors crucial for pollination and, thereby, the evolution of cheating.

Individualized versus standard diet fortification for growth and development in preterm infants receiving human milk.

BACKGROUND: Human milk as compared to formula reduces morbidity in preterm infants but requires fortification to meet their nutritional needs and to reduce the risk of extrauterine growth failure. Standard fortification methods are not individualized to the infant and assume that breast milk is uniform in nutritional content. Strategies for individualizing fortification are available; however it is not known whether these are safe, or if they improve outcomes in preterm infants. OBJECTIVES: To determine whether individualizing fortification of breast milk feeds in response to infant blood urea nitrogen (adjustable fortification) or to breast milk macronutrient content as measured with a milk analyzer (targeted fortification) reduces mortality and morbidity and promotes growth and development compared to standard, non-individualized fortification for preterm infants receiving human milk at < 37 weeks' gestation or at birth weight < 2500 grams. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 9), in the Cochrane Library; Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), on September 20, 2019. We also searched clinical trials databases and the reference lists of retrieved articles for pertinent randomized controlled trials (RCTs) and quasi-randomized trials. SELECTION CRITERIA: We considered randomized, quasi-randomized, and cluster-randomized controlled trials of preterm infants fed exclusively breast milk that compared a standard non-individualized fortification strategy to individualized fortification using a targeted or adjustable strategy. We considered studies that examined any use of fortification in eligible infants for a minimum duration of two weeks, initiated at any time during enteral feeding, and providing any regimen of human milk feeding. DATA COLLECTION AND ANALYSIS: Data were collected using the standard methods of Cochrane Neonatal. Two review authors evaluated the quality of the studies and extracted data. We reported analyses of continuous data using mean differences (MDs), and dichotomous data using risk ratios (RRs). We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS: Data were extracted from seven RCTs, resulting in eight publications (521 total participants were enrolled among these studies), with duration of study interventions ranging from two to seven weeks. As compared to standard non-individualized fortification, individualized (targeted or adjustable) fortification of enteral feeds probably increased weight gain during the intervention (typical mean difference [MD] 1.88 g/kg/d, 95% confidence interval [CI] 1.26 to 2.50; 6 studies, 345 participants), may have increased length gain during the intervention (typical MD 0.43 mm/d, 95% CI 0.32 to 0.53; 5 studies, 242 participants), and may have increased head circumference gain during the intervention (typical MD 0.14 mm/d, 95% CI 0.06 to 0.23; 5 studies, 242 participants). Compared to standard non-individualized fortification, targeted fortification probably increased weight gain during the intervention (typical MD 1.87 g/kg/d, 95% CI 1.15 to 2.58; 4 studies, 269 participants) and may have increased length gain during the intervention (typical MD 0.45 mm/d, 95% CI 0.32 to 0.57; 3 studies, 166 participants). Adjustable fortification probably increased weight gain during the intervention (typical MD 2.86 g/kg/d, 95% CI 1.69 to 4.03; 3 studies, 96 participants), probably increased gain in length during the intervention (typical MD 0.54 mm/d, 95% CI 0.38 to 0.7; 3 studies, 96 participants), and increased gain in head circumference during the intervention (typical MD 0.36 mm/d, 95% CI 0.21 to 0.5; 3 studies, 96 participants). We are uncertain whether there are differences between individualized versus standard fortification strategies in the incidence of in-hospital mortality, bronchopulmonary dysplasia, necrotizing enterocolitis, culture-proven late-onset bacterial sepsis, retinopathy of prematurity, osteopenia, length of hospital stay, or post-hospital discharge growth. No study reported severe neurodevelopmental disability as an outcome. One study that was published after our literature search was completed is awaiting classification. AUTHORS' CONCLUSIONS: We found moderate- to low-certainty evidence suggesting that individualized (either targeted or adjustable) fortification of enteral feeds in very low birth weight infants increases growth velocity of weight, length, and head circumference during the intervention compared with standard non-individualized fortification. Evidence showing important in-hospital and post-discharge clinical outcomes was sparse and of very low certainty, precluding inferences regarding safety or clinical benefits beyond short-term growth.

Comparison of Ultrasonic Thickness of Masseter Muscle Between Individuals With and Without Severe Forward Head Posture: A Cross-Sectional Study.

OBJECTIVE: In this cross-sectional descriptive-analytical study, we sought to compare the ultrasonic thickness of the masseter muscle in people with severe forward head posture vs people without forward head posture, and to determine sex differences in muscle thickness. METHODS: Thirty-eight volunteers (19 with normal head postures and 19 with severe forward head postures), aged 18 to 35 years, entered the study. The severity of the forward head posture was measured by a plumb line and the craniovertebral angle drawn on the recorded images. Based on the recorded images, the masseter muscle thickness was also measured by a 7.5-MHz linear transducer using an ultrasound device in the seated position with 3 mouth positions (closed, half open, and fully open). RESULTS: The results showed that the head posture affects masseter thickness significantly (P = .01), with masseter thickness significantly lower in the participants without severe forward head postures compared to those with severe forward head postures in the closed, half-open, and fully open mouth positions (P < .05). Comparing the mean masseter thickness across sexes showed that the masseter muscle is significantly thicker in men compared to women (P = .01). CONCLUSION: Head posture and thickness of the masseter muscle are linked, as the masseter muscle was thicker in all 3 positions in the participants with severe forward head postures.

Child Head Circumference and Placental MFSD2a Expression Are Associated to the Level of MFSD2a in Maternal Blood During Pregnancy.

Gestational diabetes mellitus (GDM) is a world-wide health challenge, which prevalence is expected to increase in parallel to the epidemic of obesity. Children born from GDM mothers have lower levels of docosahexaenoic acid (DHA) in cord blood, which might influence their neurodevelopment. Recently, the membrane transporter Major Family Super Domain 2a (MFSD2a) was associated with the selective transportation of DHA as lysophospholipids. The expression of the DHA membrane transporter MFSD2a is lower in GDM placentas, which could affect materno-fetal DHA transport. Humans with homozygous inactivating mutations in the MFSD2a gene present severe microcephaly and intellectual impairments. Herein, we intended to identify early blood biomarkers that may be of use during pregnancy to monitor the offspring development and the adequate nutritional interventions, such as nutritional supplementation, that may be selected to improve it. We evaluated MFSD2a expression in maternal blood at the third trimester of pregnancy, and its potential relationship with the expression of placental MFSD2a at delivery and child outcomes. Three groups of pregnant women were recruited: 25 controls, 23 GDM with dietary treatment, and 20 GDM with insulin treatment. Maternal and neonatal anthropometric and biochemical parameters were evaluated. MFSD2a was analyzed in placenta, blood and serum. MFSD2a protein expression in maternal blood was significantly lower in GDM groups and correlated with placental MFSD2a and Z-score neonatal head circumference during the first 6 months of life. The cord/maternal serum ratio of DHA, a solid indicator of materno-fetal DHA transport, was reduced in GDM groups and correlated with MFSD2a in maternal blood at the third trimester and in placenta at delivery. This indicates that altered MFSD2a levels in maternal blood during pregnancy might influence placental nutrient transport and fetal neurodevelopment. Furthermore, MFSD2a levels in maternal blood on the third trimester were inversely correlated to DHA in maternal serum lyso-PL. Thus, the level of MFSD2a in maternal blood could be used as a potential biomarker for the early detection of disturbances of MFSD2a expression during pregnancy and the subsequent consequences for the neurodevelopment of the child, as well as it may help to choose the optimal treatment approach for the affected subjects.

Development of accurate human head models for personalized electromagnetic dosimetry using deep learning.

The development of personalized human head models from medical images has become an important topic in the electromagnetic dosimetry field, including the optimization of electrostimulation, safety assessments, etc. Human head models are commonly generated via the segmentation of magnetic resonance images into different anatomical tissues. This process is time consuming and requires special experience for segmenting a relatively large number of tissues. Thus, it is challenging to accurately compute the electric field in different specific brain regions. Recently, deep learning has been applied for the segmentation of the human brain. However, most studies have focused on the segmentation of brain tissue only and little attention has been paid to other tissues, which are considerably important for electromagnetic dosimetry. In this study, we propose a new architecture for a convolutional neural network, named ForkNet, to perform the segmentation of whole human head structures, which is essential for evaluating the electrical field distribution in the brain. The proposed network can be used to generate personalized head models and applied for the evaluation of the electric field in the brain during transcranial magnetic stimulation. Our computational results indicate that the head models generated using the proposed network exhibit strong matching with those created via manual segmentation in an intra-scanner segmentation task.

Pollen reverses decreased lifespan, altered nutritional metabolism and suppressed immunity in honey bees (Apis mellifera) treated with antibiotics.

Nutrition is involved in regulating multiple aspects of honey bee biology such as caste, immunity, lifespan, growth and behavioral development. Deformed wing virus (DWV) is a major pathogenic factor which threatens honey bee populations, and its replication is regulated by the nutrition status and immune response of honey bees. The alimentary canal of the honey bee is home to a diverse microbial community that provides essential nutrients and serves to bolster immune responses. However, to what extent gut bacteria affect honey bee nutrition metabolism and immunity with respect to DWV has not been investigated fully. In this study, newly emerged worker bees were subjected to four diets that contained (1) pollen, (2) pollen and antibiotics, (3) neither pollen nor antibiotics or (4) antibiotics alone. The expression level of two nutrition genes target of rapamycin (tor) and insulin like peptide (ilp1), one nutritional marker gene vitellogenin (vg), five major royal jellyprotein genes (mrjp1-5), one antimicrobial peptide regulating gene relish (rel), and DWV virus titer and its replication intermediate, negative RNA strand, were determined by qRT-PCR from the honey bees at 7 days post-antibiotic treatment. Additionally, honey bee head mass and survival rate were measured. We observed that antibiotics decreased the expression of tor and rel, and increased DWV titer and its replication activity. Expression of ilp1, mrjp1-5 and vg, and honey bee head mass were also reduced compared with bees on a pollen diet. Antibiotics also caused a significant drop in survivorship, which could be rescued by addition of pollen to the diet. Of importance, pollen could partially rescue the loss of vg and mrjp2 while also increasing the head mass of antibiotic-treated bees. Our results illuminate the roles of bacteria in honey bee nutrition, metabolism and immunity, which confer the ability to inhibit virus replication, extend honey bee lifespan and improve overall health.

On the relationship between head circumference, brain size, prenatal long-chain PUFA/5-methyltetrahydrofolate supplementation and cognitive abilities during childhood.

Head circumference in infants has been reported to predict brain size, total grey matter volume (GMV) and neurocognitive development. However, it is unknown whether it has predictive value on regional and subcortical brain volumes. We aimed to explore the relationship between several head circumference measurements since birth and distributions of GMV and subcortical volumes at later childhood. We examined seventy-four, Caucasian, singleton, term-born infants born to mothers randomised to receive fish oil and/or 5-methyltetrahydrofolate or placebo prenatal supplementation. We assessed head circumference at birth and at 4 and 10 years of age and cognitive abilities at 7 years of age. We obtained brain MRI at 10 years of age, on which we performed voxel-based morphometry, cortical surface extraction and subcortical segmentation. Analyses were controlled for sex, age, height, weight, family status, laterality and total intracranial volume. Prenatal supplementation did not affect head circumference at any age, cognitive abilities or total brain volumes. Head circumference at 4 years presented the highest correlation with total GMV, white matter volume and brain surface area, and was also strongly associated with GMV of frontal, temporal and occipital areas, as well as with caudate nucleus, globus pallidus, putamen and thalamus volumes. As relationships between brain volumes in childhood and several outcomes extend into adulthood, we have found that ages between 0 and 4 years as the optimal time for brain growth; postnatal factors might have the most relevant impact on structural maturation of certain cortical areas and subcortical nuclei, independent of prenatal supplementation.

Externalization of remote microphone signals using a structural binaural model of the head and pinna.

In a remote microphone (RM) system, a talker speaks into a microphone and the signal is transmitted to the hearing aids worn by the hearing-impaired listener. A difficulty with remote microphones, however, is that the signal received at the hearing aid bypasses the head and pinna, so the acoustic cues needed to externalize the sound source are missing. The objective of this paper is to process the RM signal to improve externalization when listening through earphones. The processing is based on a structural binaural model, which uses a cascade of processing modules to simulate the interaural level difference, interaural time difference, pinna reflections, ear-canal resonance, and early room reflections. The externalization results for the structural binaural model are compared to a left-right signal blend, the listener's own anechoic head-related impulse response (HRIR), and the listener's own HRIR with room reverberation. The azimuth is varied from straight ahead to 90° to one side. The results show that the structural binaural model is as effective as the listener's own HRIR plus reverberation in producing an externalized acoustic image, and that there is no significant difference in externalization between hearing-impaired and normal-hearing listeners.

Direct-Current Electric Field Distribution in the Brain for Tumor Treating Field Applications: A Simulation Study.

Tumor Treating Fields (TTFields) in combination with chemotherapy and/or radiotherapy have been clinically reported to provide prolonged overall survival in glioblastoma patients. Alternating electric fields with frequencies of 100~300 kHz and magnitudes of 1~3 V/cm are shown to suppress the growth of cancer cells via interactions with polar molecules within dividing cells. Since it is difficult to directly measure the electric fields inside the brain, simulation models of the human head provide a useful tool for predicting the electric field distribution. In the present study, a three-dimensional finite element head model consisting of the scalp, the skull, the dura, the cerebrospinal fluid, and the brain was built to study the electric field distribution under various applied potentials and electrode configurations. For simplicity, a direct-current electric field was used in the simulation. The total power dissipation and temperature elevation due to Joule heating in different head tissues were also evaluated. Based on the results, some guidelines are obtained in designing the electrode configuration for personalized glioblastoma electrotherapy.

Maternal Vitamin D Status and the Relationship with Neonatal Anthropometric and Childhood Neurodevelopmental Outcomes: Results from the Seychelles Child Development Nutrition Study.

Vitamin D has an important role in early life; however, the optimal vitamin D status during pregnancy is currently unclear. There have been recent calls for pregnant women to maintain circulating 25-hydroxyvitamin D (25(OH)D) concentrations >100 nmol/L for health, yet little is known about the long-term potential benefits or safety of achieving such high maternal 25(OH)D concentrations for infant or child health outcomes. We examined maternal vitamin D status and its associations with infant anthropometric and later childhood neurocognitive outcomes in a mother-child cohort in a sun-rich country near the equator (4.6° S). This study was conducted in pregnant mothers originally recruited to the Seychelles Child Development Nutrition Study. Blood samples (n = 202) taken at delivery were analysed for serum 25-hydroxyvitamin D (25(OH)D) concentrations. Multiple linear regression models assessed associations between maternal 25(OH)D and birth weight, infant head circumference, and neurocognitive outcomes in the children at age 5 years. Mothers were, on average, 27 years of age, and the children's average gestational age was 39 weeks. None of the women reported any intake of vitamin D supplements. Maternal 25(OH)D concentrations had a mean of 101 (range 34-218 nmol/L) and none were deficient (<30 nmol/L). Maternal 25(OH)D concentrations were not associated with child anthropometric or neurodevelopmental outcomes. These findings appear to indicate that a higher vitamin D status is not a limiting factor for neonatal growth or neurocognitive development in the first 5 years of life. Larger studies with greater variability in vitamin D status are needed to further explore optimal cut-offs or non-linear associations (including for maternal health) that might exist among populations with sub-optimal exposure.

Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle-Eastern females.

BACKGROUND: Studies on the relative impact of body mass index in women in childbearing age and gestational weight gain on neonatal outcomes are scarce in the Middle East. OBJECTIVES: The primary objective of this research was to assess the impact of maternal body mass index (BMI) and gestational weight gain (GWG) on neonatal outcomes. The effect of maternal age and folic acid supplementation before and during pregnancy was also examined. SUBJECTS AND METHODS: This is a retrospective cross sectional observational study of 1000 full term deliveries of women enrolled thru the National Collaborative Perinatal Neonatal Network, in Lebanon. Maternal characteristics such as age, BMI and GWG and neonatal outcomes such as weight, height, head circumference and Apgar score were the primary studied variables in this study. Total maternal weight gain were compared to the guidelines depicted by the Institute of Medicine (IOM). RESULTS: The negative outcomes of newborns such as lean body weight and macrosomia were significantly present in women who gained respectively below or above the IOM's cut-off points. Pregestational body mass index influenced significantly the infants' birth weight, in both the underweight and obese categories. Birth height, head circumference and Apgar score were not influenced by pregestational body mass index or gestational weight gain. No significant associations were found between maternal age and pregestational body mass index and gestational weight gain. CONCLUSION: Studies evaluating the impact of weight before and during pregnancy on neonatal outcomes and anthropometrics measurements are lacking in the Middle East. Our results highlight the importance of nutritional counseling in order to shed the extra weights before conceiving and monitor weight gain to avoid the negative impact on feto-maternal health.

Early and intensive nutritional strategy combining parenteral and enteral feeding promotes neurodevelopment and growth at 18months of corrected age and 3years of age in extremely low birth weight infants.

AIM: To evaluate whether aggressive nutrition can improve long-term neurodevelopmental outcomes and growth in extremely low birth weight (ELBW) infants born appropriate for gestational age (AGA). METHODS: This single-center cohort study included 137 ELBW AGA infants born in two epochs. The first group received standard nutrition (SN; n=79) consisting of amino acids started at 0.5g/kg/day on Day 4 of life and increased to 1.0g/kg/day. The second aggressive nutrition (AN) group received amino acids started at 1.5-2.0g/kg/day within 24h of life and increased to 3.5g/kg/day. Parenteral and enteral feedings were combined in both groups. Neurodevelopmental outcomes by the Kyoto Scale of Psychological Development and growth were followed up to 18months of corrected age or 3years of age and compared by univariate and multivariate analyses. RESULTS: Baseline characteristics were similar between the two groups. At 3years of age, AN children had a significantly greater mean value of head circumference, but not length or weight, than SN children (49.1 vs 48.0cm, p=0.014). The cognitive-adaptive (C-A) score in the AN group was also significantly higher than that in the SN group (98.3 vs 91.9 at 18months, p=0.039 and 89.5 vs 83.1 at 3years, p=0.047). AN infants born ≥26weeks of gestation were less likely to develop borderline disability in C-A, language-social and overall developmental scores compared to gestational age-matched SN infants. CONCLUSION: Parenteral and enteral AN after birth improved the long-term cognitive neurodevelopment in ELBW AGA infants, especially in those born ≥26weeks of gestational age, however results need to be confirmed in a larger, multi-site randomized trial.

The benefit of head orientation to speech intelligibility in noise.

Spatial release from masking is traditionally measured with speech in front. The effect of head-orientation with respect to the speech direction has rarely been studied. Speech-reception thresholds (SRTs) were measured for eight head orientations and four spatial configurations. Benefits of head orientation away from the speech source of up to 8 dB were measured. These correlated with predictions of a model based on better-ear listening and binaural unmasking (r = 0.96). Use of spontaneous head orientations was measured when listeners attended to long speech clips of gradually diminishing speech-to-noise ratio in a sound-deadened room. Speech was presented from the loudspeaker that initially faced the listener and noise from one of four other locations. In an undirected paradigm, listeners spontaneously turned their heads away from the speech in 56% of trials. When instructed to rotate their heads in the diminishing speech-to-noise ratio, all listeners turned away from the speech and reached head orientations associated with lower SRTs. Head orientation may prove valuable for hearing-impaired listeners.

The Ratio of Docosahexaenoic Acid and Arachidonic Acid in Infant Formula Influences the Fatty Acid Composition of the Erythrocyte Membrane in Low-Birth-Weight Infants.

OBJECTIVE: The arachidonic acid (ARA) and docosahexaenoic acid (DHA) contents in the infant formula influence on the growth and development of low-birth-weight infants (LBWI). In Japan, many infant formulas are fortified only with DHA. We investigated the safety and efficacy of an infant formula (H2025A) fortified with DHA and ARA (DHA/ARA ratio of 2:1, the same as that in Japanese breast milk). METHODS: In this randomized double-blind trial, 35 LBWI were randomly allocated to 2 groups fed with H2025A or an infant formula fortified only with DHA (control formula) after discharge from the NICU. The duration of this study was one month, and the growth and fatty acid composition of the erythrocyte membrane were compared between the 2 groups. RESULTS: No difference was found in the body weight gain, height gain and head circumstance gain development between the 2 groups, and no adverse event occurred in both groups. The ARA content of the erythrocyte membrane after feeding for 1 month was significantly higher in the H2025A group than in the control group. On analysis adjusted with the breast-fed ratio, the ARA and DHA contents were significantly higher in the H2025A group. CONCLUSION: It was suggested that H2025A significantly increased the ARA and DHA contents of the erythrocyte membrane of LBWI compared to the contents of the control formula.

Correlation between calcium and phosphorus in cord blood and birth size in term infants.

BACKGROUND: Calcium supplementation during pregnancy was suggested to affect fetal growth. We aimed to investigate the association between calcium and phosphorus in cord blood and birth size parameters in term infants. METHODS: The study included 70 pregnant women and their neonates. Birth weight, birth length and head circumference of the neonates were measured. Cord blood samples were obtained at delivery. Maternal and cord blood calcium, phosphorus and parathyroid hormone were measured. The association between variables was evaluated with Pearson correlation coefficient. RESULTS: Cord blood calcium levels were significantly positively correlated with birth weight, birth length and head circumference (r=0.308 P=0.009, r=0.324 P=0.006, r=0.296 P=0.013 respectively). Cord phosphorus was significantly positively correlated with birth length (r=0.358 P=0.002). In subjects with higher phosphorus levels cord calcium were more strongly correlated with birth weight, birth length and head circumference than in the overall group (r=0.487 P=0.003, r=0.515 P=0.002, r=0.396 P=0.018 respectively). CONCLUSIONS: Cord blood calcium and phosphorus levels are associated with birth size parameters. There may be interactions between calcium and phosphorus to affect fetal growth.

The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.

OBJECTIVE: This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. STUDY DESIGN: We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n=1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. RESULTS: Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4kg) was associated with a 283g (95%CI: 279-286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4kg) (250g; 95% CI: 245-255). Women with a PPW <43kg or who gained <8kg during their pregnancy were more likely to give birth to a SGA (OR 2.9: 95%CI 1.9-4.5, OR 3.3: 95%CI 2.2-5.1) or LBW infant (OR 3.1: 95%CI 1.5-6.2, OR 3.4: 95%CI 1.6-7.2), respectively. CONCLUSIONS: These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW <43kg or a GWG <8kg are at greatest risk for poor birth outcomes in this setting. Preconception counseling and clinical care to obtain a healthy weight prior to pregnancy along with routine obstetric care on gestational weight gain is critical to improve birth outcomes. TRIAL REGISTRATION: NCT01665378 (https://clinicaltrials.gov/show/NCT01665378).

The electric field distribution in the brain during TTFields therapy and its dependence on tissue dielectric properties and anatomy: a computational study.

Tumor treating fields (TTFields) are a non-invasive, anti-mitotic and approved treatment for recurrent glioblastoma multiforme (GBM) patients. In vitro studies have shown that inhibition of cell division in glioma is achieved when the applied alternating electric field has a frequency in the range of 200 kHz and an amplitude of 1-3 V cm(-1). Our aim is to calculate the electric field distribution in the brain during TTFields therapy and to investigate the dependence of these predictions on the heterogeneous, anisotropic dielectric properties used in the computational model. A realistic head model was developed by segmenting MR images and by incorporating anisotropic conductivity values for the brain tissues. The finite element method (FEM) was used to solve for the electric potential within a volume mesh that consisted of the head tissues, a virtual lesion with an active tumour shell surrounding a necrotic core, and the transducer arrays. The induced electric field distribution is highly non-uniform. Average field strength values are slightly higher in the tumour when incorporating anisotropy, by about 10% or less. A sensitivity analysis with respect to the conductivity and permittivity of head tissues shows a variation in field strength of less than 42% in brain parenchyma and in the tumour, for values within the ranges reported in the literature. Comparing results to a previously developed head model suggests significant inter-subject variability. This modelling study predicts that during treatment with TTFields the electric field in the tumour exceeds 1 V cm(-1), independent of modelling assumptions. In the future, computational models may be useful to optimize delivery of TTFields.

Physiological correction of lingual dysfunction with the "Tongue Right Positioner": Beneficial effects on the upper airways.

Several studies have demonstrated the beneficial role of functional tongue therapy in stabilizing treatments for dental malocclusion and treating sleep-disordered breathing (SDB). The aim of this retrospective study was to evaluate the effect on the upper airways of the Tongue Right Positioner device (TRP) used for the correction of atypical swallowing. We analyzed lateral headfilms of 94 orthodontic patients aged between 11 and 17, before the start of treatment and after establishment of mature swallowing, treated with the TRP (TRP group) or by reeducation exercises (control group). In the TRP group, the establishment of mature swallowing occurs twice as fast as in the control group. This led to thinning of the floor of the mouth (-8.38%, P<0.001) linked to anteroposterior enlargement of the pharynx (+10.48%, P<0.01), both probably due to an increase in genioglossal and styloglossal muscle tone and correction of cranio-cervical posture (+2.52%, P<0.01). These results are not dependent on the type of orthodontic treatment. They suggest that the TRP could be used in the treatment of SDB.

Numerical calculation of listener-specific head-related transfer functions and sound localization: Microphone model and mesh discretization.

Head-related transfer functions (HRTFs) can be numerically calculated by applying the boundary element method on the geometry of a listener's head and pinnae. The calculation results are defined by geometrical, numerical, and acoustical parameters like the microphone used in acoustic measurements. The scope of this study was to estimate requirements on the size and position of the microphone model and on the discretization of the boundary geometry as triangular polygon mesh for accurate sound localization. The evaluation involved the analysis of localization errors predicted by a sagittal-plane localization model, the comparison of equivalent head radii estimated by a time-of-arrival model, and the analysis of actual localization errors obtained in a sound-localization experiment. While the average edge length (AEL) of the mesh had a negligible effect on localization performance in the lateral dimension, the localization performance in sagittal planes, however, degraded for larger AELs with the geometrical error as dominant factor. A microphone position at an arbitrary position at the entrance of the ear canal, a microphone size of 1 mm radius, and a mesh with 1 mm AEL yielded a localization performance similar to or better than observed with acoustically measured HRTFs.