Antibiotic use during pregnancy and the risk of preterm birth: a population-based Swedish cohort study.

OBJECTIVES: To assess the impact of gestational antibiotics on the risk of preterm birth, since a healthy maternal microbiome may be protective. METHODS: Population-based cohort study including all first pregnancies in Sweden (2006-16). The association between gestational and recent pre-conception systemic antibiotics and preterm birth was assessed by multivariable logistic regression presented as ORs and 95% CIs, adjusted for comorbidities (hypo- and hyperthyroidism, hypertension, or diabetes mellitus pre-gestation), trimester, antibiotic class and treatment duration. RESULTS: Compared with non-users, antibiotic exposure was associated with increased risks of preterm birth in mothers with comorbidities (OR = 1.32, 95% CI 1.18-1.48) and without (OR = 1.09, 95% CI 1.06-1.13). Pre-conception use showed no association, while risk was increased for first and second trimester use and decreased for third trimester use. The increased risks were seen for the following antibiotic groups in mothers without and with comorbidities, respectively: macrolides, lincosamides and streptogramins (OR = 1.63, 95% CI 1.45-1.83; OR = 2.48, 95% CI 1.72-3.56); quinolones (OR = 1.60, 95% CI 1.32-1.94; OR = 2.11, 95% CI 1.12-4.03); non-penicillin ß-lactams (OR = 1.15, 95% CI 1.07-1.24; OR = 1.39, 95% CI 1.07-1.83); other antibacterials (OR = 1.09, 95% CI 1.03-1.14; 1.38, 95% CI 1.16-1.63); and penicillins (OR = 1.04, 95% CI 1.01-1.08; 1.23, 95% CI 1.09-1.40). Antibiotic indications were not available, which could also affect preterm birth. CONCLUSIONS: Antibiotic use during pregnancy was associated with an increased risk of preterm birth, especially in mothers with chronic diseases.

A meta-analysis of the executive function components inhibition, shifting, and attention in intellectual disabilities.

BACKGROUND: Executive function is a concept for higher-order cognitive functions, which have the role of controller and modulator of cognitive abilities. The consensus in the literature is that people with an intellectual disability perform significantly lower on executive function tasks than groups matched on chronological age. The comparison with groups matched on mental age is less clear. Therefore, the objective of this meta-analysis was to investigate to what extent executive function is impaired in people with intellectual disability compared with a typically developing control group matched on mental age. It was also investigated if the executive function component and intellectual disability aetiology moderated the effect. METHODS: Eligibility criteria were participants with intellectual disability (IQ ≤ 75) without a dual diagnosis; a comparison group matched on mental age; executive function outcome reported in a group comparison study design with n ≥ 10. Working memory tasks and ratings of executive function were not included. The literature search yielded 6637 potentially interesting articles. Twenty-six studies (with 99 effect sizes) including 1395 participants were included in the quantitative synthesis. RESULTS: A multilevel random-effects meta-analysis found that people with intellectual disability performed statistically significantly lower than the mental age-matched group on the executive function tasks, g = -0.34, 95% confidence interval = [-0.53, -0.16]. However, the heterogeneity between effect sizes was large. The intellectual disability aetiology moderator was significant, but it only reduced the heterogeneity marginally. CONCLUSION: The overall conclusion is that individuals with an intellectual disability have more problems with executive function tasks than mental age-matched controls. Limitations are the large unexplained variance and the remarkably high number (69) of different tests that were used, which make more detailed conclusions problematic. This meta-analysis implies that future studies need to be of better quality, to have higher power, and to a higher degree use the same executive function tests.

Search for Lepton Number and Flavor Violation in K

Searches for the lepton number violating K^{+}→π^{-}µ^{+}e^{+} decay and the lepton flavor violating K^{+}→π^{+}µ^{-}e^{+} and π^{0}→µ^{-}e^{+} decays are reported using data collected by the NA62 experiment at CERN in 2017-2018. No evidence for these decays is found and upper limits of the branching ratios are obtained at 90% confidence level: B(K^{+}→π^{-}µ^{+}e^{+})<4.2×10^{-11}, B(K^{+}→π^{+}µ^{-}e^{+})<6.6×10^{-11} and B(π^{0}→µ^{-}e^{+})<3.2×10^{-10}. These results improve by 1 order of magnitude over previous results for these decay modes.

Cognitive abilities and life experience in everyday planning in adolescents with intellectual disabilities: Support for the difference model.

BACKGROUND: The literature on planning ability in individuals with intellectual disability (ID) provides no clarity on whether their ability matches their mental age (MA) or not. Perhaps can planning experience explain the mixed results. The current study investigated to what extent cognitive abilities and life experience can explain everyday planning ability in individuals with ID and to what extent results from everyday planning tasks support the developmental or the difference model of ID. METHOD: Planning tests, cognitive ability tasks and a self-rated life experience form were administered to 71 adolescents with ID and 62 children with a typical development matched on MA. RESULTS: Adolescents with ID exhibited planning ability according to their MA. Regression analyses showed that the predictors of planning differed between the groups. The cognitive measures could predict planning in both groups, but life experience only contributed positively to planning in the MA group, whereas chronological age was negatively correlated with successful planning in the ID group. CONCLUSIONS AND DISCUSSION: The results support the difference model of ID. When matched on MA, the individuals with ID will solve the planning task in a qualitatively different manner. Additionally, the participants with ID could not utilise their life experience when solving the planning task, contrary to the MA group. Practitioners should be aware that individuals with ID might need more everyday planning training throughout adolescence. To support adolescents with ID, practitioners may focus on supporting the individual's cognitive abilities rather than relying on their prior knowledge.

Repetition of contaminating question types when children and youths with intellectual disabilities are interviewed.

BACKGROUND: The present study examined the effects of repeating questions in interviews investigating the possible sexual abuse of children and youths who had a variety of intellectual disabilities. We predicted that the repetition of option-posing and suggestive questions would lead the suspected victims to change their responses, making it difficult to understand what actually happened. Inconsistency can be a key factor when assessing the reliability of witnesses. MATERIALS: Case files and transcripts of investigative interviews with 33 children and youths who had a variety of intellectual disabilities were obtained from prosecutors in Sweden. The interviews involved 25 females and 9 males whose chronological ages were between 5.4 and 23.7 years when interviewed (M = 13.2 years). RESULTS: Six per cent of the questions were repeated at least once. The repetition of focused questions raised doubts about the reports because the interviewees changed their answers 40% of the time. CONCLUSIONS: Regardless of the witnesses' abilities, it is important to obtain reports that are as accurate and complete as possible in investigative interviews. Because this was a field study, we did not know which responses were accurate, but repetitions of potentially contaminating questions frequently led the interviewees to contradict their earlier answers. This means that the interviewers' behaviour diminished the usefulness of the witnesses' testimony.

Formation of bile acids in man: conversion of cholesterol into 5-beta-cholestane-3-alpha, 7-alpha, 12-alpha-triol in liver homogenates.

The mechanisms of the conversion of cholesterol into bile acids in man were studied by examining the metabolism of cholesterol-1,2-(3)H, cholest-5-ene-3beta,7alpha-diol-7beta-(3)H, tritiumlabeled 7alpha-hydroxycholest-4-en-3-one, 7alpha,12alpha-dihydroxycholest-4-en-3-one, and cholest-5-ene-3beta,7alpha,12alpha-triol in fractions of liver homogenates. The 20,000 g supernatant fluid catalyzed the conversion of cholesterol into cholest-5-ene-3beta,7alpha-diol, 7alpha-hydroxycholest-4-en-3-one, 7alpha-12alpha-dihydroxycholest-4-en-3-one, and 5beta-cholestane-3alpha,7alpha,12alpha-triol. In the presence of microsomal fraction fortified with NAD(+), cholest-5-ene-3beta,7alpha-diol was converted into 7alpha-hydroxycholest-4-en-3-one, and when this fraction was fortified with NADPH small amounts of cholest-5-ene-3beta-7alpha,12alpha-triol were formed. 7alpha-Hydroxycholest-4-en-3-one was metabolized into 7alpha-12alpha-dihydroxycholest-4-en-3-one in the presence of microsomal fraction fortified with NADPH and into 5beta-cholestane-3alpha,7alpha-diol in the presence of 100,000 g supernatant fluid. Cholest-5-ene-3beta,7alpha,12alpha-triol was converted into 7alpha,12alpha-dihydroxycholest-4-en-3-one in the presence of microsomal fraction fortified with NAD(+). The 100,000 g supernatant fluid catalyzed the conversion of 7alpha,12alpha-dihydroxycholest-4-en-3-one into 5beta-cholestane-3alpha,7alpha,12alpha-triol. The sequence of reactions in the conversion of cholesterol into 5beta-cholestane-3alpha,7alpha-diol and 5beta-cholestane-3alpha,7alpha,12alpha-triol, the subcellular localization of the enzymes, and the cofactor requirements were found to be the same as those described for rat liver.

Digital Support for Persons with Cognitive Impairment.

Cognitive impairment may cause difficulties in planning and initiating daily activities, as well as remembering to do what is scheduled. This study investigates the effectiveness of an interactive web-based mobile reminder calendar that sends text messages to the users mobile phone as support in everyday life, for persons with cognitive impairment due to neurological injury/diagnoses. The study has a randomised controlled trail design with data collection at baseline and at follow-up sessions after two and four months. Data collection started in August 2016 and continues until December 2017. The interactive web-based mobile reminder calendar may give the needed support to remind the person and thus increase the ability to perform activities and to be independence in everyday life. Preliminary results will be presented regarding what effect the interactive web-based mobile reminder calendar have for the participants performance of everyday life activities as well as perceived quality of life.

Bile acid synthesis in humans.

Metabolic pathways involved in the conversion of cholesterol to cholic and chenodeoxycholic acids have been investigated in bile fistula patients treated with a number of labeled potential bile acid intermediates. The findings of the present report indicate that the human liver cell has the capacity to synthesize both primary bile acids via multiple routes from cholesterol and 7 alpha-hydroxycholesterol. Evidence has been obtained for the existence of a major pathway to chenodeoxycholic acid via the 26-hydroxylation of 7 alpha-hydroxycholest-4-en-3-one. Cholic acid is synthesized preferentially via pathways from 5 beta-cholestane 3 alpha, 7 alpha-diol and a pathway from cholesterol not involving an initial 7 alpha-hydroxylation.

A quantitative evaluation of the conversion of 25-hydroxycholesterol to bile acids in man.

The present study was directed toward providing additional information in man on the nature of a potential alternative pathway to cholic acid not involving an initial 7 alpha-hydroxylation of cholesterol. Two bile fistula patients and one normal subject each received 25-hydroxy[G-3H]cholesterol; [14C]cholic and [14C]chenodeoxycholic acids were also simultaneously administered to one bile fistula patient and normal subject. The labeled 25-hydroxycholesterol was found to be poorly converted to primary bile acids by all three patients; the range of conversion was 9.7 to 18.9%. Cholic acid was favored over chenodeoxycholic acid by a margin of about 1.4/1. It is concluded that a pathway to primary bile acid via the 25-hydroxylation of cholesterol is of minor importance under conditions of normal or accelerated synthesis in man.

Limitations of a pencil beam approach to photon dose calculations in the head and neck region.

The inherent limitations of a specific pencil beam model have been studied when applied to a cylindrical geometry simulating the neck region. A comparison is made between measured and calculated absorbed dose in a cylindrical phantom. The goal is to quantify the deviations in the absorbed dose level, i.e., the dose per monitor unit, when photons are used for the treatment of head and neck tumours. Square fields ranging from 5 x 5 up to 30 x 30 cm2 are studied for photon beam energies of 60Co, 4, 6 and 18 MV. Ionisation chamber measurements have been performed in the cylinder as well as in two other configurations in order to trace the origin of possible deviations. For 18 MV no significant deviations are found between measurement and calculation in the cylindrical configuration. For the lower energies, an overestimation of the calculated dose in the cylindrical configuration up to about 6% for a 20 x 20-cm2 60Co field has been found. These deviations have been traced to the basic approximation for the integration volume for phantom scatter calculations inherent in this pencil beam implementation.

The effects of tropospheric ozone and elevated carbon dioxide on potato (Solanum tuberosum L. cv. Bintje) growth and yield.

An open-top chamber experiment with field grown potato (Solanum tuberosum L. cv. Bintje) was performed in the south-west of Sweden in 1998. The experiment was aimed to investigate individual and interactive impacts of elevated ozone (O(3)) and carbon dioxide (CO(2)) on potato growth and yield. Treatments were ambient and elevated CO(2) with or without the addition of 20 nmol mol(-1) O(3). In addition, plants were grown in ambient air plots. Plants grown in elevated CO(2) and O(3) had a reduced tuber yield, compared to control, by 2% and 8%, respectively. These effects were, however, not statistically significant. Elevated CO(2) caused a significantly larger number of tubers of lower average size, while elevated O(3) induced significantly lower tuber dry matter content. The number of tuber initials (tubers <15 mm) found at harvest was significantly lower in elevated O(3). Visible O(3) leaf injury appeared earlier and the number of yellow leaves 89 days after emergence was significantly larger in elevated O(3). In elevated CO(2), haulm dry weight was significantly (15%) lower at harvest and the haulm/tuber ratio was significantly reduced. There were significant interactive effects of O(3) and CO(2) on the final number of leaves and on stem height. Plants in elevated CO(2) reached final stem height earlier than in the other treatments. In summary, it was concluded: (a) that anticipated future O(3) levels are likely to have a negative impact on potato growth, although tuber yield effects may be hard to demonstrate experimentally in this plant due to large variation; (b) that whether any possible beneficial effect of elevated CO(2) on the magnitude of tuber yield will be expressed, depend on the climatic conditions prevailing; and (c) that potato growth responses to CO(2) and O(3) are not simply additive.

An ozone flux-response relationship for wheat.

Six open-top chamber experiments with field-grown wheat Triticum aestivum L. (five with spring wheat and one with winter wheat) were combined to test which of the two ozone exposure indices, AOT40 and CFO(3), that provided the most consistent relationship between relative yield loss and ozone exposure. AOT40 is the accumulated exposure over a threshold ozone concentration of 40 nl l(-1), while CFO(3) is the cumulative flux of ozone (uptake) to the flag leaves. The ozone uptake of the flag leaves was estimated using a stomatal conductance model, sensitive to phenology, light, vapour pressure deficit (VPD) and temperature in combination with measurements of the boundary layer conductance in the open-top chambers. Both indices were calculated for the grain-filling period, defined as the time from anthesis until 2 weeks before harvest. The duration of the grain-filling period was shown to be closely related to the rate of accumulation of thermal time above a base temperature of 0 degrees C. The CFO(3) index provided a much more consistent pattern in terms of ozone effects compared to the AOT40 index. This was especially the case for spring wheat, for which a linear regression between relative yield and CFO(3) using all five data sets is presented. According to the stomatal conductance model, VPD limited daytime stomatal conductance in warm and dry years, while temperature was the most important limiting factor during daytime in cool and humid years. The effect of light was mainly to delimit the time period of the day during which substantial uptake of ozone took place. It is concluded that, compared to the AOT40 index, the more mechanistically relevant flux-based index CFO(3) will estimate larger yield loss in the relatively humid parts of western and northern Europe, while smaller yield loss will be estimated for the dry summer climates in south and central Europe. The use of an ozone flux threshold, similar to the cut-off concentration 40 nl l(-1) in AOT40, did not improve the performance of the CFO(3) index.

Lead exposure and biological effects in pied flycatchers (Ficedula hypoleuca) before and after the closure of a lead mine in northern Sweden.

Mining activities affect the surrounding environment by increasing exposure to metals. In this study, metal accumulation and its effects on reproduction and health of pied flycatcher (Ficedula hypoleuca) nestlings were monitored before and up to five years after a lead mine and enrichment plant closed down. The lead concentration in moss, nestling blood, liver and feces all indicated decreased lead exposure by at least 31% after closure, although only blood lead decreased significantly. Although the birds responded fairly well to the changed atmospheric deposition (based on moss samples), concentrations were still higher compared with birds in a reference area, and breeding was affected at the mine (smaller clutches and higher mortality). Surviving nestlings suffered from lower hemoglobin levels, mean cell hemoglobin concentrations and inhibited delta-aminolevulinic acid dehydratase activity. Lead poisoning contributed to poor health and adverse reproductive effects, but other factors (e.g. increased parasitic load) probably also affected the birds.