Maternal occupational exposure to asthmogens during pregnancy and risk of asthma in 7-year-old children:a cohort study

OBJECTIVES: The objective of this study was to examine whether maternal exposure to asthmogens during pregnancy is associated with the development of asthma in 7-year-old Danish children, taking atopic status and sex into consideration. DESIGN: The study is a prospective follow-up of a birth cohort. SETTING AND PARTICIPANTS: A total of 41 724 women and their children from The Danish National Birth Cohort were categorised according to maternal occupational exposure. Exposure information was obtained by combining job title in pregnancy and 18 months after pregnancy with a commonly used asthma Job Exposure Matrix. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was parent-reported asthma among their 7-year-old children in an internet-based questionnaire. Secondary outcome was asthma among the same children with or without atopic dermatitis and among boys and girls, respectively. RESULTS: Prenatal exposure to low molecular weight (LMW) agents was borderline associated with asthma in children with OR 1.17 (0.95 to 1.44) for children with atopic dermatitis and 1.10 (0.98 to 1.22) for children without. Maternal postnatal exposure was associated with asthma (OR 1.15 (1.04 to 1.28). After mutual adjustment,postnatal exposure (OR 1.13 (0.99 to 1.29) and the combined effects of prenatal and postnatal exposure (OR 1.34 (1.19 to 1.51)) seem to increase the risk of asthma in children. No significant associations were observed for other prenatal or postnatal exposures. The gender of the child did not modify the aforementioned associations. CONCLUSIONS: Maternal occupational exposures during pregnancy do not seem to be a substantial risk factor for the development of asthma in 7-year-old children. Maternal prenatal and postnatal exposures to LMW agents may predispose the propensity of the children to develop asthma. Future studies should prioritise the characterisation of the timing of exposure in relation to the birth

Impaired Cerebral Autoregulation during Head Up Tilt in Patients with Severe Brain Injury

Early mobilization is of importance for improving long-term outcome for patients after severe acquired brain injury. A limiting factor for early mobilization by head-up tilt is orthostatic intolerance. The purpose of the present study was to examine cerebral autoregulation in patients with severe acquired brain injury and a low level of consciousness. Fourteen patients with severe acquired brain injury and orthostatic intolerance and fifteen healthy volunteers were enrolled. Blood pressure was evaluated by pulse contour analysis, heart rate and RR-intervals were determined by electrocardiography, middle cerebral artery velocity was evaluated by transcranial Doppler, and near-infrared spectroscopy determined frontal lobe oxygenation in the supine position and during head-up tilt. Cerebral autoregulation was evaluated as the mean flow index calculated as the ratio between middle cerebral artery mean velocity and estimated cerebral perfusion pressure. Patients with acquired brain injury presented an increase in mean flow index during head-up tilt indicating impaired autoregulation (P < 0.001). Spectral analysis of heart rate variability in the frequency domain revealed lower magnitudes of ~0.1 Hz spectral power in patients compared to healthy controls suggesting baroreflex dysfunction. In conclusion, patients with severe acquired brain injury and orthostatic intolerance during head-up tilt have impaired cerebral autoregulation more than one month after brain injury

Darker Cities due to the Energy Crisis and the need for context-specific urban lighting

Outdoor lighting has been dimmed or turned off in European municipalities due to the energy crisis. Dimming of outdoor lighting levels led to energy savings, advantages for biodiversity and less light pollution. But the dimming also triggers the basic human assumption that bright light is connected to safety and darkness is connected to fear. To discuss this basic assumption, human experience of dimmed lighting and perceived safety is explored through three case studies. One study explores human experiences of dimmed street lighting during energy crises, the second study investigates dimmed lighting levels around public transportation, and the third study is an example of a context-specific adaptation of street lighting in a residential area. The case studies reveal that dimmed lighting levels, minimized contrasts, and context-specific lighting can lead to an increased connectedness to the spatial and social urban context and an increased feeling of perceived safety. Thus, more light doesn't always lead to more perceived safety. With a dimmed general lighting level, it is possible to introduce additional subtle lighting layers, structured in a lighting hierarchy to further enhance spatial and social qualities in outdoor contexts in the dark hours. in constructing both.</p