In the current SARS-CoV-2 pandemic, there has been worldwide debate on the use of corticosteroids in COVID-19. In the recent RECOVERY trial, evaluating the effect of dexamethasone, a reduced 28-day ...mortality in patients requiring oxygen therapy or mechanical ventilation was shown. Their results have led to considering amendments in guidelines or actually already recommending corticosteroids in COVID-19. However, the effectiveness and safety of corticosteroids still remain uncertain, and reliable data to further shed light on the benefit and harm are needed.
The aim of this systematic review and meta-analysis was to evaluate the effectiveness and safety of corticosteroids in COVID-19.
A systematic literature search of RCTS and observational studies on adult patients was performed across Medline/PubMed, Embase and Web of Science from December 1, 2019, until October 1, 2020, according to the PRISMA guidelines. Primary outcomes were short-term mortality and viral clearance (based on RT-PCR in respiratory specimens). Secondary outcomes were: need for mechanical ventilation, need for other oxygen therapy, length of hospital stay and secondary infections.
Forty-four studies were included, covering 20.197 patients. In twenty-two studies, the effect of corticosteroid use on mortality was quantified. The overall pooled estimate (observational studies and RCTs) showed a significant reduced mortality in the corticosteroid group (OR 0.72 (95%CI 0.57-0.87). Furthermore, viral clearance time ranged from 10 to 29 days in the corticosteroid group and from 8 to 24 days in the standard of care group. Fourteen studies reported a positive effect of corticosteroids on need for and duration of mechanical ventilation. A trend toward more infections and antibiotic use was present.
Our findings from both observational studies and RCTs confirm a beneficial effect of corticosteroids on short-term mortality and a reduction in need for mechanical ventilation. And although data in the studies were too sparse to draw any firm conclusions, there might be a signal of delayed viral clearance and an increase in secondary infections.
Young children living in technology-based communities are using touch-screen tablets (e.g. iPads) to engage with the digital world at an early age. The intuitive touch-screen interface, easily ...downloadable apps (applications) and mobility of tablets drive their increasing popularity with pre-schoolers. This review examines research to date on tablets, apps and emergent literacy in young children in the home and at pre-school. Evidence is building that suggests tablets have the potential to foster emergent writing and letter knowledge. Although the impact of tablets on emergent literacy is not yet fully known, developing themes highlight potential benefits and hindrances of tablets for emergent literacy. Two important considerations are the quality of emergent literacy apps and the importance of scaffolding young children's use of tablets at home and pre-school to support emergent literacy development. Directions for future research and recommendations for parents and teachers are discussed. Author abstract
Frontotemporal dementia (FTD) is a heterogeneous clinical syndrome associated with frontotemporal lobar degeneration (FTLD) as a relatively consistent neuropathological hallmark feature. However, the ...discoveries in the past decade of many of the relevant pathological proteins aggregating in human FTD brains in addition to several new FTD causing gene mutations underlined that FTD is a diverse condition on the neuropathological and genetic basis. This resulted in a novel molecular classification of these conditions based on the predominant protein abnormality and allows most cases of FTD to be placed now into one of three broad molecular subgroups; FTLD with tau, TAR DNA‐binding protein 43 or FET protein accumulation (FTLD‐tau, FTLD‐TDP and FTLD‐FET respectively). This review will provide an overview of the molecular neuropathology of non‐tau FTLD, insights into disease mechanisms gained from the study of human post mortem tissue as well as discussion of current controversies in the field.
Due to recent advances in technology, social robots are emerging as educational tools with the potential to enhance early language and literacy skills in young children. Social robots are defined as ...machines that can socially interact and communicate intelligently with humans. A review of the literature was conducted to explore current knowledge on social robots and early language and literacy learning in typically developing children (0 to 8 years old). The database search terms were “social robots” AND (literacy OR language) AND “education”. Twelve databases were searched and 13 studies met the search criteria. Five key themes were identified: A theoretical framework for learning with social robots; Child engagement with social robots; Social robots and language and literacy activities; Social robots and language and literacy learning; and Characteristics of social robots for education. Few studies were found that specifically addressed social robots and early literacy learning. Although social robots were found to support early language learning, further research is needed to investigate social robots and early literacy learning in young children.
Fifteen-year-old adolescents (N = 109) in a longitudinal study of child development were recruited to examine differences in DNA methylation in relation to parent reports of adversity during the ...adolescents' infancy and preschool periods. Microarray technology applied to 28,000 cytosine—guanine dinucleotide sites within DNA derived from buccal epithelial cells showed differential methylation among adolescents whose parents reported high levels of stress during their children's early lives. Maternal stressors in infancy and paternal stressors in the preschool years were most strongly predictive of differential methylation, and the patterning of such epigenetic marks varied by children's gender. To the authors' knowledge, this is the first report of prospective associations between adversities in early childhood and the epigenetic conformation of adolescents' genomic DNA.
This paper concerns forest parameter retrieval from polarimetric interferometric synthetic aperture radar (PolInSAR) data considering two layers, one for the ground under the vegetation and one for ...the volumetric canopy. A model is designed to combine a physical model-based polarimetric decomposition with the random-volume-over-ground (RVoG) PolInSAR parameter inversion approach. The combination of a polarimetric scattering media model with a PolInSAR RVoG vertical structure model provides the possibility to separate the ground and the volume coherency matrices based on polarimetric signatures and interferometric coherence diversity. The proposed polarimetric decomposition characterizes volumetric media by the degree of polarization orientation randomness and by the particle scattering anisotropy. Using the full model enhances the estimation of the vertical forest structure parameters by enabling us to estimate the ground-to-volume ratio, the temporal decorrelation, and the differential extinction. For forest vegetation observed at L-band, this model accounts for the ground topography, forest and canopy layer heights, wave attenuation in the canopy, tree morphology in the form of the angular distribution and the effective shapes of the branches, and the contributions from the ground level consisting of surface scattering and double-bounce ground-trunk interactions, as well as volumetric understory scattering. The parameter estimation performance is evaluated on real airborne L-band SAR data of the Traunstein test site, acquired by the German Aerospace Center (DLR)'s E-SAR sensor in 2003, in both single- and multibaseline configurations. The retrieved forest height is compared with the ground-truth measurements, revealing, for the given test site, an average root-mean-square error (rmse) of about 5 m in the repeat-pass configuration. This implies an improvement in rmse by over 2 m in comparison to the pure coherence-based RVoG PolInSAR parameter inversion.
Abstract
Background
Patellar fractures have a comparatively low incidence compared to all fracture frequencies of the musculoskeletal system. However, surgical management is crucial to prevent ...postoperative complications that affect the knee joint. The purpose of the present study was to evaluate the incidence of postoperative complications and onset of postoperative osteoarthritis related to the chosen technique of patellar fracture management.
Methods
In a retrospective cohort study consecutive managed, isolated patella fractures were reviewed for demographic data, trauma mechanism, patella fracture type, fixation technique and postoperative complications. The results were documented radiographically and clinically and analysed statistically. The reporting followed the STROBE guidelines.
Results
A total of 112 patients were eligible for data evaluation. Surgical management of comminuted patellar fractures with small fragment screws showed significant fewer postoperative complications compared to other fixation techniques (8%,
p
< 0.043). The incidence of posttraumatic infection was significantly higher following the hybrid fixation technique with cannulated screws and tension wire than following the other analysed techniques (
p
= 0.024). No postoperative wound infection was observed after screw fixation or locking plate fixation. Symptomatic hardware was most frequently seen after tension-band fixation. Onset of posttraumatic osteoarthritis was most often found after the hybrid fixation technique (55%).
Conclusion
Surgical management of patellar fractures remains crucial but fracture fixation using plating systems or small fragment screws is least associated with postoperative complications.
Trial registration
Trial registration number (DRKS):00027894.
BACKGROUND: Drought is a major limitation to plant productivity. Various options are available for increasing water availability and sustaining growth of crop plants in drought-prone environments. ...SCOPE: After a general introduction to the problems of water availability, this review focuses on a critical evaluation of recent progress in unravelling mechanisms for modifying plant growth responses to drought. CONCLUSIONS: Investigations of key regulatory mechanisms integrating plant growth responses to water deficits at the whole-organism, cellular and genomic levels continue to provide novel and exiting research findings. For example, recent reports contradict the widespread conception that root-derived abscisic acid is necessarily involved in signalling for stomatal and shoot-growth responses to soil water deficits. The findings bring into question the theoretical basis for alternate-side root-irrigation techniques. Similarly, recent reports indicate that increased ABA production or increased aquaporin expression did not lead to improved drought resistance. Other reports have concerned key genes and proteins involved in regulation of flowering (FT), vegetative growth (DELLA), leaf senescence (IPT) and desiccation tolerance (LEA). Introgression of such genes, with suitable promoters, can greatly impact on whole-plant responses to drought. Further developments could facilitate the introduction by breeders of new crop varieties with growth physiologies tailored to improved field performance under drought. Parallel efforts to encourage the introduction of supplementary irrigation with water made available by improved conservation measures and by sea- or brackish-water desalination, will probably provide comprehensive solutions to coping with drought-prone environments.
Young children interact with touch screen tablets at home and this may impact upon emergent literacy. This study examined home access and use of touch screen tablets, as reported by parents, in ...Australian pre-schoolers (N=109) aged 3-5 years and whether this was associated with emergent literacy skills (letter name and sound, numeral identification, print concepts and name writing). The children were from 11 pre-schools across south-east Queensland. Children with greater access to tablets were found to have higher letter sound and name writing skills. No relationships were found between time on tablets and emergent literacy skills. The quality of experiences rather than time spent on tablets may be important especially when viewed within a socio-cultural framework. Most parents (69%) reported that tablets were easy for their child to operate and believed tablets support early literacy development (70%). 53% believed children should have access to tablets at pre-school. Tablets have the potential to foster emergent literacy although this may depend upon the quality of digital interactions. Author abstract, ed
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