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The consequences of mating system and dispersal potential on the genetic structure of...
Adriel Sierra
Marta Alonso-Garcia

Adriel Sierra

and 3 more

March 30, 2023
Patch size and connectivity are the main predictors of population demographic and genetic stability. Habitat fragmentation continues at unprecedented rates justly affecting plant functional connectivity worldwide. However, few terrestrial plant groups have sufficiently foreshortened generation times in which to empirically disentangle the demographic and genetic consequences of reduced patch size and connectivity. Herein, we combine evidence from long-term (15 yr.) population censuses of two epiphyllous bryophytes and population genetic estimates in an experimentally fragmented Amazonian landscape to create a profile of the eco-evolutionary impacts of reduced habitat connectivity. Single nucleotide polymorphisms (SNPs) derived from Genotyping by Sequencing were used to analyze genetic patterns among fragmented (1-, 10- and 100-ha) and continuous forests. In the context of the world’s most diverse biome, fragmentation induces marked effects on plant population demography and genetic differentiation. Declines in colonization events in small patches (1- and 10-ha), associated with reduced colony densities, led to accelerated genotypic differentiation (genetic drift) compared to 100-ha fragment and continuous forests. Furthermore, the mating system was related to differential sensitivities to the intensity of fragmentation. Unexpectedly, the unisexual species (hypothesized to be more challenged in terms of spore output) was characterized by higher migration rates among smaller patches than its bisexual counterpart. These results point to the complex and unpredictable patterns revealed when life history strategies, demography, and plant genetic structure are simultaneously evaluated in the context of the long-term effects of reduced landscape connectivity.
Improving Reliability of Protection Communication in a 5G Slice
Petra Raussi
Heli Kokkoniemi-Tarkkanen

Petra Raussi

and 4 more

March 30, 2023
5G network slicing is a promising solution to prioritize time-critical protection communication in wireless networks. However, recent trends indicate that a 5G slice could encompass all smart grid applications lacking the necessary granularity. At the same time, while substation communication standards recommend prioritization of protection communication traffic to improve reliability, these recommendations are only for wired connections. Therefore, this paper investigates traffic shaping and uplink (UL) bitrate adaptation of video stream based on existing commercial solutions as methodologies for prioritizing the protection communication in a 5G slice. These methodologies are validated in an experimental setup combining controller-hardware-in-the-loop (CHIL) simulation with a quality of service (QoS) measurement system. The system under test consists of commercial 5G networks, commercial intelligent electronic devices (IEDs), and merging units to validate the methodologies on three smart grid applications: fault location, line differential, and intertrip protection. The results show improvement in protection communication when traffic shaping and UL bitrate adaptation are applied. Traffic shaping even improves prioritization with a wired connection.
Deep Learning-based MISO-NOMA-HBF-BFNN to Improve Channel Capacity for B5G
Md Shoriful Islam
shaon04

Md Shoriful Islam

and 2 more

March 30, 2023
In this study, multiple-input single-output based non-orthogonal multiple access (MISO-NOMA) with hybrid beamforming (HBF) (MISO-NOMA-HBF) and beamforming neural network (BFNN) for cell edge user (CEU) are integrated (termed as MISO-NOMA-HBF-BFNN) for mmWave based beyond 5G cellular communication system to support multiple users simultaneously and provide significantly improved user channel capacities and sum channel capacity (SC) as well. Simulation results illustrated the effectiveness of the proposed MISO-NOMA-HBF-BFNN scheme over the existing MISO-NOMA with HBF and MISO-OMA with HBF-BFNN based schemes in case of user capacities and SC as well.
The German influenza gap 2021 - a multifactorial view
Lars Homagk
Lutz Hornung

Lars Homagk

and 1 more

March 30, 2023
The end of the 2019/2020 influenza season was already registered in early summer 2020, and in the following season. There was an nearly complete absence of influenza. So far, the sometimes strict Covid-19 containment measures with contact restrictions and the obligation to wear a mask have been mentioned as reasons. This study looks for further reaseons and from several perspectives in order to develop strategies for a representative recording of influenza cases derive. In contrast to influenza A/B, the other viral respiratory pathogens (adenovirus, parainfluenza virus and RS virus) do not show any significant reduction. From 2020, the number of reports of respiratory infections to the RKI increased from an average of 300,000 annual reports by 2019 to 1,985,985 reports in 2020, over 5,453,017 reports in 2021 and to 29,681,158 in 2022. On the other hand cases of incapacity to work due to respiratory infections fell from 31.0% in 2019 to 15.3% in 2021. Influenza-specific diagnoses (ICD: J10.1-3) were encrypted 33,727 times in 2021, in 2020 there were still 109,846. The reduction in influenza A and B from 2020 as a result of the comprehensive Covid-19 control measures, including the obligation to wear masks, cannot be considered a major reason; rather, the aspect of underreporting of influenza cases plays a significant role. Therefore, the reporting quantity of the sentinal practices should be considered and the recording of incapacity diagnoses should be taken into account.
Using Wearables to Manage Atrial Fibrillation: Pushing the Boundaries with Consumer D...
Marco Perez

Marco Perez

March 30, 2023
The irregular pulse notification (IPN) algorithm on the Apple Watch (Apple Inc., Cupertino, CA) was not designed for use by atrial fibrillation (AF) patients. It is not FDA cleared for use in AF patients. Before this study by Dr. Wasserlauf and colleagues, there were no studies of its accuracy in AF patients. Yet, many AF patients could not resist the temptation to use the feature. In the Apple Heart Study1, even after making it clear that patients with AF were not eligible for the study, 174 (18%) of the participants who received an irregular pulse notification and connected with a study visit doctor confessed that they knew they already had AF and were excluded from the study. These participants were just too curious to pass up the opportunity to see what the new technology was all about.
MATURITY MODEL OF SCRUM TEAM'S COMPETENCIES IN GLOBAL SOFTWARE DEVELOPMENT
Anita Hidayati
Eko K. Budiardjo

Anita Hidayati

and 3 more

March 30, 2023
Maturity models guide the achievement of competency maturity levels. This study aims to develop a competency maturity model for Scrum team members in Global Software Development (GSD environments. Each Scrum role, such as Product Owner, Scrum Master, and Developers, has a unique set of competencies at each maturity level. We developed the maturity model by conducting in-depth interviews with global Scrum practitioners. We also conducted a comparative study to determine the most appropriate maturity model reference. The maturity model’s validation uses expert judgment involving experts in academia and industry. The maturity model in this study is inspired by CMMI 2.0, while Scrum and Agile Maturity models inform the maturity levels. Results reveal that each maturity level consists of a set of practice areas in which each practice area may exist in several maturity levels. The practice area contains a set of competencies with an arrangement of capability levels based on the standards by adopting the Skills Framework for the Information Age (SFIA) and the European e-Competence Framework (e-CF). In conclusion, the resulting maturity model is helpful as a guide for increasing competence gradually and measurably. This model can also develop assessment tools to measure competency maturity levels.
Alzheimer’s disease pathology programmed by gut-derived disparity: A comprehensive un...
Aytak Khabbaz
Alka Hasani

Aytak Khabbaz

and 7 more

March 30, 2023
The human gut is colonized with microbial species that not only resides but also facilitate in many functions. The alterations in this gastrointestinal microbiota directly influence many body systems including, central nervous system (CNS) disorders such as Alzheimer’s disease (AD). The term microbiota is thus a determinant factor in the association between illness and health. AD, the most common form of dementia, is a neurodegenerative disorder associated with impaired cognition and cerebral accumulation of amyloid-β peptides (Aβ). Germ-free animals have provided enormous data on the existence of dysbiosis and its conversion by fecal microbiota transplantation. The main cause of AD is unknown and it is estimated that by 2050 the number of patients will increase up to three times. Bacteria populating the gut microbiota (GM) can secrete large amounts of amyloids and lipopolysaccharides, which might contribute to the modulation of signaling pathways and the production of proinflammatory cytokines associated with the pathogenesis of AD. The Gut-brain axis links the emotional and cognitive center of the brain with intestinal activities. Thus, it can be said that the dysbiosis of human microbiome could be a risk factor for AD. In this review, we provide an overview of GM and how their dysregulation accounts for the pathogenesis of AD. Illustration of the mechanisms underlying the modification of GM composition may pave the way for developing novel preventive and therapeutic approach for AD.
Bilateral axillary folliculitis due to Pseudomonas aeruginosa
Luis Paniagua
Neal Nathan

Luis Paniagua

and 2 more

March 30, 2023
IntroductionFolliculitis is inflammation of hair follicles, most commonly due to infection. Ingrown hairs and trauma from shaving or waxing promote follicular occlusion and irritation and increase risk of folliculitis.Folliculitis is classified by depth of infection. Superficial folliculitis involves the superficial part of the hair follicle (infundibulum) while deep folliculitis involves the entire hair follicle. On examination, inflammation of superficial folliculitis is restricted to the epidermis. Deep folliculitis is distinguished by widespread erythema, edema, and tenderness involving the dermis.
AlGaN/GaN heterojunction bipolar transistors with low dynamic RON,sp and Vth hysteres...
Xinyuan Wang
Lian Zhang

Xinyuan Wang

and 5 more

March 30, 2023
This paper demonstrates the dynamic characteristics of 150-V-class GaN power HBTs for the first time. At OFF-state collector bias VCEQ = 80 V, the device shows a low dynamic specific on-resistance (RON,sp) of 0.316 mΩ·cm2, which is only 4.7% higher than static RON,sp, thanks to current conductive path far from the surface. A threshold voltage (Vth) of 3.58 V extracted at 1 A/cm2 is achieved with an on/off current ratio of 2×107. The device also show a large base voltage swing of -7 to 7 V with a small Vth hysteresis of 50 mV. The low dynamic resistance degradation, high positive Vth with low Vth hysteresis, and large base voltage swing all demonstrate the great potential of GaN HBT in power switching applications.
Direct and higher-order interactions in plant communities under increasing weather pe...
Simon Reynaert
Jonas Lembrechts

Simon Reynaert

and 6 more

March 29, 2023
Climate change is increasing the weather persistence in the mid-latitudes, prolonging both dry and wet spells compared to historic averages. These newly emerging environmental conditions destabilize plant communities, but the role of species interactions in this process is unknown. Here, we tested how direct and higher-order interactions (HOIs) between species may change in synthesized grassland communities along an experimental gradient of increasing persistence in precipitation regimes. Our results indicate that species interactions (including HOIs) are an important determinant of plant performance under increasing weather persistence. Out of the 12 most parsimonious models predicting species productivity, 75 % contained significant direct interactions and 92 % significant HOIs. Inclusion of direct interactions or HOIs respectively tripled or quadrupled the explained variance of target species biomass compared to null models only including the precipitation treatment. Drought dominated the plant responses, with longer droughts increasing direct competition but also HOI-driven facilitation. Despite these counteracting changes, drought intensified net competition. Grasses were generally more involved in competitive interactions whereas legumes had a stronger affinity for facilitative interactions. Under longer drought, species affinity for nutrient rich or wet environments resulted in more negative direct interactions or HOIs, respectively. We conclude that higher-order interactions, crucially depending on species identity, only partially stabilize community dynamics under increasing weather persistence.
An Artificially Intelligent Framework for Plant Health Monitoring
Tarun Jain
Aditya

Tarun Jain

and 2 more

March 29, 2023
Plants are cultivated and consumed all over the world. They are highly nutritious and are rich in vitamins, minerals etc. However, most plants are vulnerable to biotic and abiotic diseases, which limits the yield. So, it is essential to detect and handle these diseases at the earliest to get an ample amount of produce. Computers and digital devices make this process much more effortless than manual human intervention. The general template followed by researchers is first segmenting out the diseased lesions from the leaves and then applying machine learning classifiers to differentiate between the diseases. Our proposed solution involves classification followed by lesion isolation and quantification. The techniques are automatic and require no human intervention in the segmentation steps. Additionally, most of the classification work is done on specific plant and disease combinations like cherry powdery mildew, apple rust etc., which requires retraining the classifier in the case of the introduction of a new disease-leaf pair. We tried to solve this limitation by classifying the leaf images based on the disease type, not disease-leaf pairs, as most diseases have similar infection patterns in different plants. Our study included powdery mildew, rust, and bacterial spot diseases. A classification model has been developed which classifies whether a leaf is suffering from powdery mildew, rust, bacterial spot or is healthy. A remarkable accuracy of 99.09% was observed on the test dataset. Moreover, the detection techniques are robust to various lighting conditions, leaf color patterns and symptom patterns
Analysis of the features of 105 confirmed CRISPR loci in 487 Klebsiella variicola
Yanyan Xi
Jiaxue Zhao

Yanyan Xi

and 7 more

March 29, 2023
Klebsiella variicola (K. variicola) is an emerging human pathogen, which poses a threat to public health. The horizontal gene transfer (HGT) of plasmids is an important driver for the emergence of multiple antibiotic-resistant K. variicola. The clustered regularly interspersed short palindromic repeats coupled with the CRISPR-associated genes (CRISPR/Cas) constitute an adaptive immune system in bacteria, which provide acquired immunity against HGT. However, the information about CRISPR/Cas system in K. variicola is still limited. In this study, a total of 487 genomes from NCBI database were used to analyze the characterization of CRISPR/Cas systems. 105 of the 487 genomes harbored at least one confirmed CRISPR array. Three types of CRISPR/Cas system, including types I-E, I-E*, and Ⅳ-A systems, were identified among 105 strains. The distribution of type I system was strongly associated with MLST, whereas type IV system was randomly distributed. Approximately one-third of spacer origins were homologous with plasmids or phages, indicating the role of CRISPR/Cas systems in controlling HGT. Moreover, spacers in K. variicola tended to target mobile genetic elements (MGEs) from Klebsiella pneumoniae, which provides new evidence for their interaction during evolution. Collectively, our results provide valuable insights into the role of CRISPR/Cas systems in K. variicola.
ESTIMATING THE PERMEABILITY OF A POROUS CERAMIC TILE
Abul Hasan

Abul Hasan

and 6 more

March 29, 2023
Porous ceramics are widely used for water filtering, improving heat transfer, supporting catalysts, vaporizing liquids, etc. Residential tiles used for water sealing are made from ceramic as well. Moisture infusion analysis based on Richard's equation is necessary to improve tile quality, and this analysis depends heavily on estimating the tile permeability. The current research demonstrates three techniques for calculating ceramic-tile permeability. The first technique is a theoretical model that requires information about the material's effective diameter and porosity that was obtained via scanning electron microscopy (SEM). The second suggested technique is known as mercury intrusion porosimetry (MIP). The pore size, density, pore volume, and porosity of the ceramic tiles, among other characteristics, are evaluated using mercury in this procedure. The experiment's pressure was varied from 0.1 to 60000 psi. These criteria were used to determine the tile's permeability. The last strategy addressed in this research is the falling-head permeameter (FHP) approach. This procedure involves inserting the specimen into a sealed transparent rectangular conduit. Water is then allowed to pass through it. The rate at which the water level in the duct recedes over time is associated with permeability. All the approaches yield permeability values that are in the same order-of-magnitude of 10-16 m 2 .
Land-use intensity influences European tetrapod food-webs
Christophe Botella
Pierre Gaüzère

Christophe Botella

and 9 more

March 29, 2023
Land use intensification favours particular trophic groups which can induce architectural changes in food-webs. These changes can deeply impact ecosystem functioning, stability and robustness to extinctions. However, the imprint of land management intensity on food-web architecture has rarely been characterised across large spatial extent and various land uses. We investigated the influence of land management intensity on six facets of food-web architecture for 67,051 European tetrapod communities, and its dependency on land use and climate. We found that intensification promoted lower proportions of both apex and basal species, with more connected and less compartmentalized food-webs, and unexpectedly, favoured longer trophic chains in cities and decreased omnivory in mediterranean climates. By favouring mesopredators and undermining basal tetrapods, intensification might lead to new forestry and agricultural pest outbreaks. Our results support mesopredator regulation and apex predator protection where possible, but urban and mediterranean contexts might need alternative strategies.
Derivative Pricing with Credit Risk
Tim Xiao

Tim Xiao

March 29, 2023
This article presents a new model for valuing financial contracts subject to credit risk and collateralization. We study credit default swap (CDS) contract subject to counterparty risk. There are three credit risk factors in CDS. They are credit risks from the buyer, seller and reference entity. We show that default dependency has a significant impact on the value of CDS. We also show that a fully collateralized CDS is not equivalent to a risk-free one. In other words, full collateralization cannot eliminate counterparty risk completely in the CDS market.
TNT in ammunition shells: an investigation of chemical integrity after artificial agi...
Erich Reinold
Aline Anastacio

Erich Reinold

and 4 more

March 29, 2023
Rationale: Industrial TNT contains substances other than 2-4-6-trinitrotoluene that are of primary interest for military applications. The degradation of industrial TNT by aging and by contact with steel surfaces, which represent real situations of use of the material, was investigated. There is practical knowledge about this degradation, but the literature lacks details of this process. Methods: Small steel samples used in military ammunition were covered with TNT and heated at 75 ºC for 30 days under vacuum. Some of the samples were previously painted with a red alkyd paint coating that protects the metallic surface. After aging, the TNT was scraped off the metal pieces and analyzed by scanning electron microscopy, Fourier-transform infrared spectroscopy and gas chromatography-mass spectrometry. Results: The results showed in detail how the integrity of the TNT is maintained even under thermal stress and in contact with the steel surface. Although some changes were observed in the surface appearance of the TNT, all the analyses indicated the maintenance of the chemical integrity of the industrial TNT. The only change in composition identified is related to the contamination with degradation products of the alkyd paint coating and not with the degradation processes of the TNT itself. Conclusions: Our results indicated that although there are many TNT degradation processes reported in the literature, for cases involving thermal stress degradation of TNT in solid phase in contact with metal, these processes are irrelevant. Thus, it is possible to elucidate the safety of TNT when packaged in steel artifacts, which represent the majority of military ammunition.
New technologies in electroanatomic mapping for a better mechanism characterization o...
Giovanni Volpato
Michela Casella

Giovanni Volpato

and 14 more

March 29, 2023
Background Provide a brief overview of recent technological advances that can potentially give information for treatment of different kind of arrhythmias. Methods In this report, we describe the features of Omnipolar technology (OT) using high density mapping catheter and we report five different scenario in which this new tool can give some important information to understand arrhythmia’s substrate and guide the treatment. OT combine three unipolar and two bipolar signals and provides maximum voltage regardless of electrode-wavefront orientation, local wavefront activation direction and local measurements of wave speed: it allow to create a velocity map. Results OT has been used to study different types of supraventricular tachycardias. Regarding reentry tachycardias, velocity map has allowed the characterization and definition of the impulse velocity along the dual nodal pathway and the accessory pathways (AP). As regards atrial flutter, it has successfully allowed the definition of the slowest zone of the critical isthmus and radiofrequency (RF) delivery at that point resulted in termination of the arrhythmia. During mapping of the left atrium in sinus rhythm, the velocity map allowed the identification of the course of the Bachmann’s bundle, which could potentially play a role during the ablation of persistent atrial fibrillation (AF). Conclusion OT and velocity map offer significant advantages in the management of challenging arrhythmias, and can potentially improve the efficacy of the treatment of some arrhythmias such as atrial flutter and AF.
Flexible Wearable Electronics: Present State and Future Development
Qi Zhang
Jianjia Mu

Qi Zhang

and 5 more

March 29, 2023
Wearable electronics are expected to be light, durable, flexible, and comfortable. Many fibrous, planar and tridimensional structures have been designed to realize flexible devices that can sustain geometrical deformations, such as bending, twisting, folding, and stretching normally at ambient conditions. As a flexible electrode for batteries or other devices, it possess favorable mechanical strength and large specific capacity and preserve efficient ionic and electronic conductivity with a certain shape, structure and function. To fulfill flexible energy-storage devices, much effort has been devoted to design of structures and materials with mechanical characteristics. This review attempts to critically review the state‐of‐arts with respect to materials, and structural design of devices as well as applications of the wearable electronic products. Finally, discussion present regarding to limitations of current materials, fabrication techniques, devices concerning manufacturability and performance as well as scientific understanding that must be improved prior to their wide adoption.
EFFICIENCY ANALYSIS USING FLYWHEEL ENERGY STORAGE TECHNOLOGY FOR REGENERATIVE BRAKE S...
Zeyneb Kurtulmuş
Abdulhakim Karakaya

Zeyneb Kurtulmuş

and 1 more

March 29, 2023
The increase in fossil fuel consumption used in conventional vehicles has adversely affected the amount of carbon emissions in the atmosphere. Due to this negativity, many problems such as global warming, noise pollution and cost have emerged. In order to find solutions to these problems, many studies have been carried out to increase the energy storage capacity of Electric Vehicles (EV) since 1835. EVs produced as a result of these studies work more efficiently than traditional tools. However, the driving range problem and charging time are the biggest disadvantages of these vehicles. These disadvantages are a major obstacle for EVs to replace traditional tools. In this study, an experimental study was conducted on flywheel-battery in-vehicle topologies, which are recommended to be used to increase the range in EV and hybrid electric vehicles. In the application, two flywheels with the same rotor radius and different masses were used. Energy was produced from the generator through these flywheels. This energy was employed to charge the batteries. The stored energy and power amounts were investigated depending on the variation of the moment of inertia of both flywheels at the maximum and minimum levels. As a result of this examination, it has been determined which of the flywheels with the same rotor radius but different masses is more suitable for electric vehicles.
Analysis of imatinib for therapeutic drug monitoring in patients with adjuvant and ne...
Jinglin Gao
Wanqiu Liu

Jinglin Gao

and 6 more

March 29, 2023
In China, 1100 ng/mL is used as the recommended threshold for imatinib Cssmin in therapeutic drug monitoring (TDM) for metastatic recurrence/unresectable gastrointestinal stromal tumors (GIST) patients. However, there are few studies on characteristics of imatinib Cssmin for adjuvant therapy after complete resection of GIST and neoadjuvant therapy. Consider individual differences of GIST patients, analysis of imatinib in patients with adjuvant and neoadjuvant treatment using a quantitative ultra-performance liquid chromatography coupled with tandem massspectrometry (UPLC-MS/MS) method was conducted in this study. This developed method showed good selectivity and reliability. 25 blood samples collected from October 2019 to October 2021 in 16 patients with adjuvant therapy and 9 patients with neoadjuvant therapy were determined. In the neoadjuvant treatment group, all patients initially received 400 mg/d imatinib. The range of the imatinib steady-state plasma concentration (Cssmin) was 1083-4722 ng/mL. In the adjuvant treatment group, the imatinib Cssmin was in the range of 584-2692 ng/mL after patients given at a dosage of 200, 300, 400 and 600 mg/d. There is no statistical difference in Cssmin between two groups after receiving 400 mg/d imatinib (p=0.402). Among all patients given 400 mg/d imatinib, the Cssmin was significantly correlated with gender (P=0.016).
Technical trends for the valorization of heavy metal containing hyperaccumulators in...
Jieyi Wen
Jiawen Zhou

Jieyi Wen

and 5 more

March 29, 2023
With high biodiversity and a large demand for environmental restoration, China has become a global hotspot for the investigation and application of hyperaccumulator plants aiming to effectively decontaminate polluted soils. After harvesting, the abnormally high content of heavy metals (HMs) in the aboveground tissues of hyperaccumulators requires proper treatment in downstream processes to boost the economic potential and avoid secondary pollution. This paper covers the significance of phytoextraction research in the remediation of HM-contaminated soil in China. The technical trends and the major scientific advances for the eco-friendly valorization of HM-enriched hyperaccumulators are comprehensively reviewed. A systematic survey of the thermochemical and biological routes to upcycle the hyperaccumulator biomass is conducted by emphasizing the transformation strategies for green and valuable products, along with the safe recovery of HM streams. In addition, challenges and perspectives on the valorization of hyperaccumulators in the future are presented.
BriskChain: Decentralized Function Composition for High-performance Serverless Comput...
Jing Ma
Kan Wang

Jing Ma

and 2 more

March 29, 2023
Serverless computing allows developers to create workflows for complex tasks through the composition of serverless functions. Current serverless workflow engines rely on master-side patterns which hinder the interaction between serverless functions, causing performance issues. In this paper, a decentralized worker-side pattern is proposed that provides enhanced performance by allowing each workflow function to schedule itself from the current node to the next without having to interact with the master controller. It treats the serverless workflow as a whole unit and uses a locality strategy to optimize performance. A new high-performance workflow engine called BriskChain has been implemented to demonstrate the effectiveness of this approach. Experiments on a real-world application show that BriskChain is able to achieve 2.5 times better performance than a state-of-the-art serverless workflow engine.
A Case of Close Lip Schizencephaly with absent septum pellucidum in adult presenting...
Chhabi Khadka
Umang  Gupta

Chhabi Khadka

and 4 more

March 29, 2023
A Case of Close Lip Schizencephaly with absent septum pellucidum in adult presenting with seizure disorderChhabi Khadka1, Umang Gupta2, Prakriti Bhandari3, Prabin Pandey1, Shailes Paudel3National Academy of Medical Sciences, NepalMaharajgunj Medical Campus, NepalPatan Academy of Health Sciences, NepalCorrespondenceShailes Paudel, Patan Academy of Health Sciences, Lalitpur, Nepal Email: shailespaudel@gmail.com
Maternal folic acid supplementation and the risk of ankyloglossia (tongue-tie) in inf...
Gal Rubin
Catherine Stewart

Gal Rubin

and 6 more

March 29, 2023
Background: Maternal folic acid supplementation is protective against the development of neural tube defects (NTDs) in babies. However, recent public-facing communications have raised concerns about a causal relationship between folic acid supplementation, particularly after the first trimester, and ankyloglossia (tongue-tie) in infants. Non-evidence-based communications are potentially harmful because they could adversely affect adherence to folic acid supplementation, increasing NTD occurrence. Objectives: To review evidence on the relationships between maternal folic acid supplementation during preconception and/or pregnancy and the risk of ankyloglossia in infants. Search Strategy: We searched online bibliographic databases for studies investigating the effect of maternal folic acid supplementation during preconception or pregnancy on the occurrence of ankyloglossia in offspring. Selection Criteria: Observational, interventional studies, and systematic reviews assessing the relationships between folic acid and ankyloglossia. Data Collection and Analysis: The database searches yielded 93 articles. After removing duplicates and screening titles and abstracts, 26 remained. One article was judged relevant for inclusion in analyses; a case-control study that directly mentions the relationship between folic acid supplementation and ankyloglossia Main Results: One case-control study reported that regular intake of folic acid supplements was higher in women with infants with ankyloglossia. However, this study has limitations regarding design, selection bias, and confounding, calling the findings into question. Conclusions: Insufficient evidence exists for a relationship between folic acid supplementation and ankyloglossia. Currently, the benefits of folic acid supplementation far outweigh the risks. This must be clearly communicated to patients by their clinicians during preconception and antenatal care.
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