Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures.

BACKGROUND: To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. METHODS: PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools. RESULTS: Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I2 statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low. CONCLUSIONS: Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated. SYSTEMATIC REVIEW REGISTRATION: The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).

Addressing climate change with behavioral science: A global intervention tournament in 63 countries.

Effectively reducing climate change requires marked, global behavior change. However, it is unclear which strategies are most likely to motivate people to change their climate beliefs and behaviors. Here, we tested 11 expert-crowdsourced interventions on four climate mitigation outcomes: beliefs, policy support, information sharing intention, and an effortful tree-planting behavioral task. Across 59,440 participants from 63 countries, the interventions' effectiveness was small, largely limited to nonclimate skeptics, and differed across outcomes: Beliefs were strengthened mostly by decreasing psychological distance (by 2.3%), policy support by writing a letter to a future-generation member (2.6%), information sharing by negative emotion induction (12.1%), and no intervention increased the more effortful behavior-several interventions even reduced tree planting. Last, the effects of each intervention differed depending on people's initial climate beliefs. These findings suggest that the impact of behavioral climate interventions varies across audiences and target behaviors.

Concurrence of seizures and peri-ictal delirium in the critically ill - its frequency, associated characteristics, and outcomes.

BACKGROUND: To assess the frequency, clinical features, and outcome of peri-ictal delirium in adult patients experiencing seizures during intensive care. METHODS: This observational study was conducted at a Swiss intensive care unit from 2015 to 2020. Patients aged ≥ 18 years with seizures were categorized as peri-ictal delirious (Intensive Care Delirium Screening Checklist [i.e., ICDSC] ≥ 4) or not (i.e., ICDSC < 4) within 24 h of seizures. The frequency of peri-ictal delirium and in-hospital death were defined as the primary endpoints. Illness severity and treatment characteristics between delirious and non-delirious patients were secondary endpoints. Logistic regression was used to compare in-hospital death and differences regarding clinical characteristics between delirious and non-delirious patients. RESULTS: 48% of 200 patients had peri-ictal delirium for a median of 3 days. Delirious patients were older (median age 69 vs. 62 years, p = 0.002), had lower Simplified Acute Physiology Scores II (SAPS II; median 43 vs. 54, p = 0.013), received neuroleptics more frequently (31 vs. 5%, p < 0.001), were mechanically ventilated less often (56% vs. 73%, p = 0.013) and shorter (median 3 vs. 5 days, p = 0.011), and had decreased odds for in-hospital death with delirium (OR = 0.41, 95% CI 0.20-0.84) in multivariable analyses. CONCLUSIONS: Delirium emerged in every second patient experiencing seizures and was associated with lower SAPS II, shorter mechanical ventilation, and better outcomes, contradicting assumptions that altered cerebral function, from seizures and delirium, are linked to unfavorable outcomes.

Separation of responsive and unresponsive patients under clinical conditions: comparison of symbolic transfer entropy and permutation entropy.

Electroencephalogram (EEG)-based monitoring during general anesthesia may help prevent harmful effects of high or low doses of general anesthetics. There is currently no convincing evidence in this regard for the proprietary algorithms of commercially available monitors. The purpose of this study was to investigate whether a more mechanism-based parameter of EEG analysis (symbolic transfer entropy, STE) can separate responsive from unresponsive patients better than a strictly probabilistic parameter (permutation entropy, PE) under clinical conditions. In this prospective single-center study, the EEG of 60 surgical ASA I-III patients was recorded perioperatively. During induction of and emergence from anesthesia, patients were asked to squeeze the investigators' hand every 15s. Time of loss of responsiveness (LoR) during induction and return of responsiveness (RoR) during emergence from anesthesia were registered. PE and STE were calculated at -15s and +30s of LoR and RoR and their ability to separate responsive from unresponsive patients was evaluated using accuracy statistics. 56 patients were included in the final analysis. STE and PE values decreased during anesthesia induction and increased during emergence. Intra-individual consistency was higher during induction than during emergence. Accuracy values during LoR and RoR were 0.71 (0.62-0.79) and 0.60 (0.51-0.69), respectively for STE and 0.74 (0.66-0.82) and 0.62 (0.53-0.71), respectively for PE. For the combination of LoR and RoR, values were 0.65 (0.59-0.71) for STE and 0.68 (0.62-0.74) for PE. The ability to differentiate between the clinical status of (un)responsiveness did not significantly differ between STE and PE at any time. Mechanism-based EEG analysis did not improve differentiation of responsive from unresponsive patients compared to the probabilistic PE.Trial registration: German Clinical Trials Register ID: DRKS00030562, November 4, 2022, retrospectively registered.

Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function.

Patients with brain death have by definition irreversible and complete loss of brainstem reflexes. Before a definite diagnosis of brain death can be confirmed, all potential confounders must be thoroughly excluded. Baclofen intoxication is a rare cause of brain death mimic characterised by transient deep coma and absence of brainstem reflexes and might be mistaken with brain death. We report the case of a female patient in her 70s who ingested baclofen with suicidal intent and was admitted with a deep coma and loss of all brainstem reflexes and a spontaneous burst-suppression pattern in the electroencephalography which resolved over 10 hours. After a state mimicking brain death for 6 hours, the patient experienced complete recovery. Severe baclofen intoxication can mimic brain death clinically and is associated with temporary pathological electroencephalographic findings. Awareness of this toxidrome is crucial, as appropriate management can lead to full recovery.

Large but diminishing effects of climate action nudges under rising costs.

Behavioural public policy has received broad research attention, particularly in the domain of motivating pro-environmental behaviours. We investigate how far the efficacy of arguably one the most popular behavioural policy tools (green 'default change' nudges) depends on the associated cost. On the basis of a field study involving carbon offsets for over 30,000 flights booked by more than 11,000 airline customers, we show that green defaults have a large effect on voluntary climate action, even when several hundreds of Euros are at stake. The effect fully vanishes only as costs approach approximately €800.

A large maxillary cemento-ossifying fibroma superimposed with solitary bone cyst documented over 18 years: A case report.

INTRODUCTION: Cemento-ossifying fibromas are rare, benign lesions of the head and neck regions. The origin of these lesions can be traced to the periodontal ligament, because its cells are able to form cement, lamellar bone, or fibrous tissue. CASE PRESENTATION: A rare case report of a young Caucasian female with a COF is described including follow-ups. She remained untreated for several years despite early radiographic findings of the lesion without a definitive diagnosis. The patient ultimately underwent radical surgery and the whole lesion was removed. The subsequent histological examination confirmed the clinical diagnosis of a COF. Since then, the patient has been under regular clinical and radiological follow-ups. DISCUSSION: This rare case report of a COF, documented over 18 years, shows the importance of consecutive therapy after radiologic and clinical findings, as such lesions continue growing and may subsequently lead to severe medical conditions. Therefore, complete surgical resection of COFs is advised to achieve good results in terms of health and recurrence. CONCLUSION: Long-term follow-up of patients is required as recurrences can occur for up to 10 years following treatment. Well-planned radical and wide surgical resection of these lesions has proven not only to be effective in eliminating the aetiological factors, but can also achieve decent bone regeneration and aesthetic results with almost no deformation in the surgical site.

Spectral and Entropic Features Are Altered by Age in the Electroencephalogram in Patients under Sevoflurane Anesthesia.

BACKGROUND: Preexisting factors such as age and cognitive performance can influence the electroencephalogram (EEG) during general anesthesia. Specifically, spectral EEG power is lower in elderly, compared to younger, subjects. Here, the authors investigate age-related changes in EEG architecture in patients undergoing general anesthesia through a detailed examination of spectral and entropic measures. METHODS: The authors retrospectively studied 180 frontal EEG recordings from patients undergoing general anesthesia, induced with propofol/fentanyl and maintained by sevoflurane at the Waikato Hospital in Hamilton, New Zealand. The authors calculated power spectral density and normalized power spectral density, the entropic measures approximate and permutation entropy, as well as the beta ratio and spectral entropy as exemplary parameters used in current monitoring systems from segments of EEG obtained before the onset of surgery (i.e., with no noxious stimulation). RESULTS: The oldest quartile of patients had significantly lower 1/f characteristics (P < 0.001; area under the receiver operating characteristics curve, 0.84 [0.76 0.92]), indicative of a more uniform distribution of spectral power. Analysis of the normalized power spectral density revealed no significant impact of age on relative alpha (P = 0.693; area under the receiver operating characteristics curve, 0.52 [0.41 0.63]) and a significant but weak effect on relative beta power (P = 0.041; area under the receiver operating characteristics curve, 0.62 [0.52 0.73]). Using entropic parameters, the authors found a significant age-related change toward a more irregular and unpredictable EEG (permutation entropy: P < 0.001, area under the receiver operating characteristics curve, 0.81 [0.71 0.90]; approximate entropy: P < 0.001; area under the receiver operating characteristics curve, 0.76 [0.66 0.85]). With approximate entropy, the authors could also detect an age-induced change in alpha-band activity (P = 0.002; area under the receiver operating characteristics curve, 0.69 [0.60 78]). CONCLUSIONS: Like the sleep literature, spectral and entropic EEG features under general anesthesia change with age revealing a shift toward a faster, more irregular, oscillatory composition of the EEG in older patients. Age-related changes in neurophysiological activity may underlie these findings however the contribution of age-related changes in filtering properties or the signal to noise ratio must also be considered. Regardless, most current EEG technology used to guide anesthetic management focus on spectral features, and improvements to these devices might involve integration of entropic features of the raw EEG.

Interantral alveolar ridge splitting for maxillary horizontal expansion and simultaneous dental implant insertion: A case report.

INTRODUCTION: Dental implants present an advanced technique for the rehabilitation of partial or edentulous patients. Tooth loss caused by caries, periodontal disease or systemic factors often results in a decline of the bucco-lingual alveolar ridge dimension. Within one year the initial bone width can be resorbed up to 50%. As a consequence dental implants may be limited for rehabilitation and cannot be performed in a conventional manner because of the risk of dehiscence and fenestrations. Bone blocks, guided bone regeneration (GBR), horizontal osteogenic distraction and bone grafts may be used for augmentation procedures. In case of sufficient vertical bone dimension, an alveolar ridge splitting and augmentation technique (ARST) can be conducted. This case has been reported in line with PROCESS criteria [1]. CASE PRESENTATION: We present a 51-year old female patient, who has had a full denture for about 30 years. The reason for consultation was the demand for a fixed prosthesis. Dental implants in combination of the ARST with GBR allowed us to correct horizontal deformities of the alveolar ridge. DISCUSSION: We discuss the possibility of using the ARST in the interantral region for a full arch rehabilitation of the maxilla with simultaneous dental implant placement in a narrow alveolar ridge. CONCLUSION: The ARST in addition to simultaneous implant placement with a GBR can be successfully used for a full arch rehabilitation of the maxilla in a narrow alveolar ridge.

Risk of Hospital Admissions in Patients With Atrial Fibrillation: A Systematic Review and Meta-analysis.

BACKGROUND: Atrial fibrillation (AF) is associated with multiple comorbidities and various adverse outcome events, suggesting a high risk of hospital admissions in this patient population. However, its exact incidence and potential underlying causes are not well defined. The objective of this systematic review was to investigate the incidence and risk factors for hospital admissions in patients with AF. METHODS: We systematically searched MEDLINE, EMBASE, and CENTRAL for studies providing information on all-cause hospital admissions. Studies were included if they provided information on the incidence of all-cause hospital admissions in ≥ 100 patients with AF, and had ≥ 1 year of follow-up. Incidence estimates were pooled using random-effects models. Meta-regression analysis was performed to identify characteristics associated with between-study heterogeneity. RESULTS: Thirty-five studies (n = 311,314 patients) were included. The pooled incidence of all-cause hospital admissions was 43.7 (95% confidence interval [CI], 38.5-48.9; I2 = 99.9%) per 100 person-years. In 24 studies (n = 234,028 patients) that provided information on admission causes, cardiovascular hospitalizations were more common than noncardiovascular hospitalizations (pooled incidence 26.3 [95% CI, 22.7-29.9; I2 = 99.9%] vs 15.7 [95% CI, 12.5-18.9; I2 = 99.8%] per 100 person-years). In meta-regression analyses, older age (ß = 1.4 [95% CI, 0.33-2.53], P = 0.01, R2 = 15.7%) and prevalence of chronic pulmonary disease (ß = 1.5 [95% CI, 0.57-2.45], P = 0.005, R2 = 49.8%) were associated with an increased rate of all-cause hospital admissions. CONCLUSIONS: Patients with AF have a very high risk of being admitted to the hospital, both for cardiovascular and noncardiovascular causes. The development and implementation of preventive strategies should be a public health priority.

The social insectivore: Peer and expert influence affect consumer evaluations of insects as food.

As conventional animal production is a significant contributor to anthropogenic climate change, eating of insects in Western markets has been primarily discussed from an environmental perspective. Following advances in food technology and regulation, edible insects are an emerging research topic not only in environmental sciences, but also in consumer research. To contribute to this rising interest, the present research presents consumer psychological drivers to promote insect consumption based on research on social influence. Two experiments that assessed the influence of peer (Study 1) as well as expert influence (Study 2) on acceptance indicators suggest that both types of influence are significantly associated with acceptance of insects as foods. Study 2 further reveals that the proposed effect of expert influence on acceptance of insects is moderated by insect-based disgust sensitivity in a way that expert influence is stronger for consumers low in insect-based disgust sensitivity. Taken together, our research shows that managing expectations via social influence can be an important driver to increase the adoption of insects in Western markets.

Relationship of critical dynamics, functional connectivity, and states of consciousness in large-scale human brain networks.

Recent modeling and empirical studies support the hypothesis that large-scale brain networks function near a critical state. Similar functional connectivity patterns derived from resting state empirical data and brain network models at criticality provide further support. However, despite the strong implication of a relationship, there has been no principled explanation of how criticality shapes the characteristic functional connectivity in large-scale brain networks. Here, we hypothesized that the network science concept of partial phase locking is the underlying mechanism of optimal functional connectivity in the resting state. We further hypothesized that the characteristic connectivity of the critical state provides a theoretical boundary to quantify how far pharmacologically or pathologically perturbed brain connectivity deviates from its critical state, which could enable the differentiation of various states of consciousness with a theory-based metric. To test the hypothesis, we used a neuroanatomically informed brain network model with the resulting source signals projected to electroencephalogram (EEG)-like sensor signals with a forward model. Phase lag entropy (PLE), a measure of phase relation diversity, was estimated and the topography of PLE was analyzed. To measure the distance from criticality, the PLE topography at a critical state was compared with those of the EEG data from baseline consciousness, isoflurane anesthesia, ketamine anesthesia, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. We demonstrate that the partial phase locking at criticality shapes the functional connectivity and asymmetric anterior-posterior PLE topography, with low (high) PLE for high (low) degree nodes. The topographical similarity and the strength of PLE differentiates various pharmacologic and pathologic states of consciousness. Moreover, this model-based EEG network analysis provides a novel metric to quantify how far a pharmacologically or pathologically perturbed brain network is away from critical state, rather than merely determining whether it is in a critical or non-critical state.

Incidence and predictors of atrial fibrillation progression: A systematic review and meta-analysis.

BACKGROUND: More sustained forms of atrial fibrillation (AF) are less amenable to treatment and associated with worse outcomes, but the incidence and predictors of AF progression are not well defined. OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis assessing the incidence and predictors of AF progression. METHODS: PubMed, EMBASE, and the Cochrane Library were searched from inception to August 2017. AF progression was defined as progression from paroxysmal to persistent/permanent AF or as progression from persistent to permanent AF. Random effect models were used to calculate pooled cumulative incidence rates. Predictors related to between-study variability were assessed using meta-regression analyses. RESULTS: We identified 47 studies with 27,266 patients who were followed for 105,912 patient-years. The pooled incidence of AF progression was 8.1 per 100 patient-years of follow-up (95% confidence interval [CI] 7.1-9.1 per 100 patient-years of follow-up; I2 = 98%; P < .0001). The incidence was 7.1 per 100 patient-years of follow-up (95% CI 6.2-8.0 per 100 patient-years of follow-up; across 42 studies) for progression from paroxysmal to non-paroxysmal AF as compared with 18.6 per 100 patient-years of follow-up (95% CI 8.9-28.3 per 100 patient-years of follow-up; across 5 studies) for progression from persistent to permanent AF. Higher age (ß = 5.4; 95% CI 1.4-9.4; P = .01; R2 = 14.3%) and the prevalence of hypertension (ß = 5.2; 95% CI 1.0-9.4; P = .02; R2 = 18.0%) were associated with a higher AF progression rate. Follow-up duration (ß = -4.5; 95% CI -5.8 to -3.3; P < .0001; R2 = 68.0%) and the prevalence of paroxysmal AF (ß = -9.5; 95% CI -18.7 to -0.3; P = .04; R2 = 4.4%) were inversely associated with AF progression. Together these variables explained 73.8% of the observed between-study heterogeneity. CONCLUSION: The incidence of AF progression appears to be relatively low, and the incidence seems to decrease with longer follow-up duration. Age, hypertension, baseline AF type, and follow-up duration explained a high percentage of the observed between-study heterogeneity.

When Utilitarian Claims Backfire: Advertising Content and the Uptake of Insects as Food.

A key challenge for climate change mitigation on the consumer side is to break habits that excessively lead to carbon emission. One of the culturally most robust human routines is the heavy reliance of the Western societies on conventional meat sources such as beef, pork, and poultry, which were recently accused of causing particularly high climate costs. In this light, the UN (FAO) has suggested the increasing use of insects as an alternative source of animal protein intended for human diets. Yet, insects have not reached the mainstream of Western cuisine. Currently, a frequent promotion strategy of insects is to highlight the Utilitarian benefits associated with their consumption (e.g., with respect to the environment or one's health). The present research addresses the efficacy of such claims in a consumer research study involving 180 participants recruited from the general population in Germany. Arguing based on social-cognitive research in the area of moral and environmental psychology, we hypothesized and found that a focus on beneficial, but temporally distant motives (e.g., health)-counterintuitively-decreases consumption in comparison to immediate, hedonic advertisements (e.g., tasty). Furthermore, our study provides process evidence suggesting pretrial expectations induced by a particular claim mediate the relationship between claims and consumption. Thus, the present research not only refutes a state-of-the-art approach in the promotion of insects as food, but also provides an alternative approach and process evidence by integrating psychological factors.

Cross-sectional study on the prevalence of carotid artery calcifications, tonsilloliths, calcified submandibular lymph nodes, sialoliths of the submandibular gland, and idiopathic osteosclerosis using digital panoramic radiography in a Lower Austrian subpopulation.

OBJECTIVE: Bone and soft tissue calcifications can often be visualized on panoramic radiographs, thus leading to presumptive diagnoses requiring further examinations. This cross-sectional study determined the prevalence of suspected carotid artery calcifications, tonsilloliths, calcified submandibular lymph nodes, sialoliths of the submandibular glands, and idiopathic osteosclerosis in a Lower Austrian subpopulation. METHOD AND MATERIALS: Digital panoramic radiographs (DPR) taken from 1,042 subjects for other clinical purposes between the years 2013 and 2015 were evaluated, using a standardized template. Chi-square tests and Fisher's exact test were used to evaluate the relationship between the detected calcifications and patient age as well as sex. RESULTS: Radiographic data from 490 men and 552 women (mean age of 49.2 [range 21 to 87] years) were analyzed. Two hundred and twenty calcifications were recorded in 198 subjects (19.0%), of which 100 (50.5%) were female. The mean age of participants with calcifications was 55.8 [SD 14.1] years. Radiopaque structures included carotid artery calcifications (5.7%), tonsilloliths (5.7%), calcified submandibular lymph nodes (3.6%), sialoliths of the submandibular gland (0.9%), and idiopathic osteosclerosis (5.3%) as presumptive diagnoses. In total, 196 calcifications (89.1%) were recorded in patients older than 40 years; no gender-dependent relationship could be revealed. Multiple calcification types were detected in 20 patients (11 women, 9 men). CONCLUSIONS: With a prevalence of 19.0% in the study population, calcifications observed on DPR are more spread than previously reported. Thus, with patients of increasing age, DPR should be regarded as an important tool for basic screening of suspicious calcifications necessitating further diagnostic assessments.

Bariatric surgery among patients with heart failure: a systematic review and meta-analysis.

Background: Bariatric surgery reduces cardiovascular risk in obese patients. Heart failure (HF) is associated with an increased perioperative risk following bariatric surgery. This systematic review aimed to assemble the evidence on bariatric surgery in patients with known HF and the potential effect of bariatric surgery on incident HF in obese patients without prevalent HF. Methods: We performed a comprehensive literature search up to 30 September 2017 and included studies comparing bariatric surgery to non-surgical treatment in patients with known presurgical HF. To assess whether bariatric surgery has any effect on incident HF, we also assembled studies looking at new-onset HF among patients without HF prior to surgery. Results: We found five observational studies (0 randomised trials) comparing bariatric surgery with non-surgical treatment in patients with a diagnosis of HF prior to surgery. A review of the available studies (n=676 patients) suggested reduced admission rates for HF exacerbation and increased left ventricular ejection fraction after bariatric surgery. No meta-analysis was possible due to the heterogeneous nature of these studies. Seven studies (one randomised trial) reported data on new-onset HF in obese patients without HF prior to bariatric surgery (n=111 127 patients). When comparing surgical to non-surgical treatment groups, the pooled univariable and multivariable HRs for incident HF were 0.28 (95% CI 0.13 to 0.55) and 0.44 (95% CI 0.36 to 0.55), respectively. Conclusion: In this systematic review, no randomised trial assessed the benefits and risks of bariatric surgery in obese patients with concomitant HF. Available studies do, however, show that surgery might prevent incident HF.

Placental Proteomics Reveal Insights into Fetal Alcohol Spectrum Disorders.

BACKGROUND: Fetal alcohol spectrum disorders (FASD) describe many of the well-known neurodevelopmental deficits afflicting children exposed to alcohol in utero. The effects of alcohol on the maternal-fetal interface, especially the placenta, have been less explored. We herein hypothesized that chronic binge alcohol exposure during pregnancy significantly alters the placental protein profile in a rat FASD model. METHODS: Pregnant rats were orogastrically treated daily with alcohol (4.5 g/kg, gestational day [GD] 5 to 10; 6.0 g/kg, GD 11 to 19) or 50% maltose dextrin (isocalorically matched pair-fed controls). On GD 20, placentae were collected, flash-frozen, and stored until tissues were homogenized. Protein lysates were denatured, reduced, captured on a 10-kDa spin filter, and digested. Peptides were eluted, reconstituted, and analyzed by a Q Exactive™ Hybrid Quadrupole-Orbitrap™ mass spectrometer. RESULTS: Mass spectrometry (MS) analysis identified 2,285 placental proteins based on normalized spectral counts and 2,000 proteins by intensity-based absolute quantification. Forty-five placental proteins were significantly (p < 0.05) altered by gestational alcohol exposure by both quantification approaches. These included proteins directly related to alcohol metabolism; specific isoforms of alcohol dehydrogenase and aldehyde dehydrogenase were up-regulated in the alcohol group. Ingenuity analysis identified ethanol degradation as the most significantly altered canonical pathway in placenta, and fetal/organ development as most altered function, with increased risk for metabolic, neurological, and cardiovascular diseases. Physiological roles of the significantly altered proteins were related to early pregnancy adaptations, implantation, gestational diseases, fetal organ development, neurodevelopment, and immune functions. CONCLUSIONS: We conclude that the placenta is a valuable organ not only to understand FASD etiology but it may also serve as a diagnostic tool to identify novel biomarkers for detecting the outcome of fetal alcohol exposure. Placental MS analysis can offer sophisticated insights into identifying alcohol metabolism-related enzymes and regulators of fetal development.

Coherence of BOLD signal and electrical activity in the human brain during deep sevoflurane anesthesia.

INTRODUCTION: Changes in neural activity induce changes in functional magnetic resonance (fMRI) blood oxygenation level dependent (BOLD) signal. Commonly, increases in BOLD signal are ascribed to cellular excitation. OBJECTIVE: The relationship between electrical activity and BOLD signal in the human brain was probed on the basis of burst suppression EEG. This condition includes two distinct states of high and low electrical activity. METHODS: Resting-state simultaneous EEG and BOLD measurements were acquired during deep sevoflurane anesthesia with burst suppression EEG in nineteen healthy volunteers. Afterwards, fMRI volumes were assigned to one of the two states (burst or suppression) as defined by the EEG. RESULTS: In the frontal, parietal and temporal lobes as well as in the basal ganglia, BOLD signal increased after burst onset in the EEG and decreased after onset of EEG suppression. In contrast, BOLD signal in the occipital lobe was anticorrelated to electrical activity. This finding was obtained consistently in a general linear model and in raw data. CONCLUSIONS: In human brains exhibiting burst suppression EEG induced by sevoflurane, the positive correlation between BOLD signal and electrical brain activity could be confirmed in most gray matter. The exceptional behavior of the occipital lobe with an anticorrelation of BOLD signal and electrical activity might be due to specific neurovascular coupling mechanisms that are pronounced in the deeply anesthetized brain.

Exposure to Hedione Increases Reciprocity in Humans.

Cooperation among unrelated humans is frequently regarded as a defining feature in the evolutionary success of our species. Whereas, much research has addressed the strategic and cognitive mechanisms that underlie cooperation, investigations into chemosensory processes have received very limited research attention. To bridge that gap, we build on recent research that has identified the chemically synthesized odorant Hedione (HED) as a ligand for the putative human pheromone receptor (VN1R1) expressed in the olfactory mucosa, and hypothesize that exposure to HED may increase reciprocity. Applying behavioral economics paradigms, the present research shows that exposure to the ligand causes differentiated behavioral effects in reciprocal punishments (Study 1) as well as rewards (Study 2), two types of behaviors that are frequently regarded as essential for the development and maintenance of cooperation.

Long-term clinical and radiologic documentation of a maxillary odontogenic myxoma from early clinical signs to implant-supported prosthodontic rehabilitation: Case report and review of the literature.

Odontogenic myxoma (OM) is a non-metastasizing neoplasm of mesenchymal origin, arising in the tooth-bearing areas of the jaws. When regarding the whole spectrum of differential diagnoses for osteolytic jaw lesions, OM constitutes a benign tumor rarely located in the maxilla. Radiographically, displacement of teeth and frequent involvement of the sinus will be found with advanced maxillary OM. The tumor can be removed by means of several techniques, ranging from conservative measures to extended surgical procedures that differ according to type of bone resection and reconstruction of the defect. This report documents 10 years of follow-up in a patient suffering from a Type IV lesion of maxillary OM; with a radiographically proven growth extending into the right maxillary sinus, the patient underwent a segmental maxillectomy. After a tumor-free period of 5 years, the alveolar ridge splitting technique (ARST) was modified to insert dental implants into the horizontally deficient alveolar ridge of the maxilla, and final rehabilitation by means of a conditionally removable prosthetic reconstruction followed. In this paper, the most striking clinical signs of OM with which the dentist should be familiar are reviewed, and we discuss the advantages of segmental maxillectomy in case of an OM, along with the possibility of using ARST, aiming at prosthetic rehabilitation by placement of dental implants in cases of moderate alveolar ridge deficiency after tumor resection.