Lack of evidence for effects of lockdowns on stillbirth rates during the SARS-CoV-2 pandemic in Bavaria: analysis of the Bavarian perinatal survey from 2010 to 2020.

BACKGROUND: Internationally, potential effects of national SARS-CoV-2-related lockdowns on stillbirth rates have been reported, but data for Germany, including risk factors for fetal pregnancy outcome, are lacking. The aim of this study is to compare the stillbirth rates during the two first lockdown periods in 2020 with previous years from 2010 to 2019 in a large Bavarian cohort. METHODS: This study is a secondary analysis of the Bavarian perinatal data from 2010 to 2020, including 349,245 births. Univariate and multivariable regression analyses were performed to investigate the effect of two Bavarian lockdowns on the stillbirth rate in 2020 compared to the corresponding periods from 2010 to 2019. RESULTS: During the first lockdown, the stillbirth rate was significantly higher compared to the reference period (4.04 vs. 3.03 stillbirths per 1000 births; P = 0.03). After adjustment for seasonal and long-term trends, this effect can no longer be observed (P = 0.2). During the second lockdown, the stillbirth rate did not differ in univariate (3.46 vs. 2.93 stillbirths per 1000 births; P = 0.22) as well as in multivariable analyses (P = 0.68), compared to the years 2010 to 2019. CONCLUSION: After adjustment for known long-term effects, in this study we did not find evidence that the two Bavarian lockdowns had an effect on the rate of stillbirths.

Limited Effects of SARS-CoV-2 Pandemic-related Lockdowns and Reduced Population Mobility on Preterm Birth Rates: A Secondary Analysis of Bavarian Obstetric Quality Parameters from 2010 to 2020.

Introduction International studies on preterm birth rates during COVID-19 lockdowns report different results. This study examines preterm birth rates during lockdown periods and the impact of the mobility changes of the population in Bavaria, Germany. Material and Methods This is a secondary analysis of centrally collected data on preterm births in Bavaria from 2010 to 2020. Preterm births (< 37 weeks) in singleton and twin pregnancies during two lockdowns were compared with corresponding periods in 2010 - 2019. Fisher's exact test was used to compare raw prevalence between groups. Potential effects of two fixed lockdown periods and of variable changes in population mobility on preterm birth rates in 2020 were examined using additive logistic regression models, adjusting for long-term and seasonal trends. Results Unadjusted preterm birth rates in 2020 were significantly lower for singleton pregnancies during the two lockdown periods (Lockdown 1: 5.71% vs. 6.41%; OR 0.88; p < 0.001; Lockdown 2: 5.71% vs. 6.60%; OR = 0.86; p < 0.001). However, these effects could not be confirmed after adjusting for long-term trends (Lockdown 1: adj. OR = 0.99; p = 0.73; Lockdown 2: adj. OR = 0.96; p = 0.24). For twin pregnancies, differences during lockdown were less marked (Lockdown 1: 52.99% vs. 56.26%; OR = 0.88; p = 0.15; Lockdown 2: 58.06% vs. 58.91%; OR = 0.97; p = 0.70). Reduced population mobility had no significant impact on preterm birth rates in singleton pregnancies (p = 0.14) but did have an impact on twin pregnancies (p = 0.02). Conclusions Reduced preterm birth rates during both lockdown periods in 2020 were observed for singleton and twin pregnancies. However, these effects are reduced when adjusting for long-term and seasonal trends. Reduced population mobility was associated with lower preterm birth rates in twin pregnancies.

Loss of enhancer of zeste homologue 2 (EZH2) at tumor invasion front is correlated with higher aggressiveness in colorectal cancer cells.

PURPOSE: Enhancer of zeste homolog 2 (EZH2) is associated with epigenetic gene silencing and aggressiveness in many tumor types. However, the prognostic impact of high EZH2 expression is controversially discussed for colorectal cancer. For this reason, we immunohistochemically analyzed EZH2 expression in 105 specimens from colon cancer patients separately for tumor center and invasion front. METHODS: All sections from tissue microarrays were evaluated manually and digitally using Definiens Tissue Studio software (TSS). To mirror-image the EZH2 status at the tumor invasion front, we treated HCT116 colon cancer cells with the EZH2 inhibitor 3-Deazaneplanocin A (DZNep) and studied the growth of in ovo xenografts in the chorioallantoic membrane (CAM) assay. RESULTS: We showed a significant decrease in EZH2 expression and the repressive H3K27me3 code at the tumor invasion front as supported by the TSS-constructed heatmaps. Loss of EZH2 at tumor invasion front, but not in tumor center was correlated with unfavorable prognosis and more advanced tumor stages. The observed cell cycle arrest in vitro and in vivo was associated with higher tumor aggressiveness. Xenografts formed by DZNep-treated HCT116 cells showed loosely packed tumor masses, infiltrative growth into the CAM, and high vessel density. CONCLUSION: The differences in EZH2 expression between tumor center and invasion front as well as different scoring and cutoff values can most likely explain controversial literature data concerning the prognostic value of EZH2. Epigenetic therapies using EZH2 inhibitors have to be carefully evaluated for each specific tumor type, since alterations in cell differentiation might lead to unfavorable results.

Using data from online geocoding services for the assessment of environmental obesogenic factors: a feasibility study.

BACKGROUND: The increasing prevalence of obesity is a major public health problem in many countries. Built environment factors are known to be associated with obesity, which is an important risk factor for type 2 diabetes. Online geocoding services could be used to identify regions with a high concentration of obesogenic factors. The aim of our study was to examine the feasibility of integrating information from online geocoding services for the assessment of obesogenic environments. METHODS: We identified environmental factors associated with obesity from the literature and translated these factors into variables from the online geocoding services Google Maps and OpenStreetMap (OSM). We tested whether spatial data points can be downloaded from these services and processed and visualized on maps. True- and false-positive values, false-negative values, sensitivities and positive predictive values of the processed data were determined using search engines and in-field inspections within four pilot areas in Bavaria, Germany. RESULTS: Several environmental factors could be identified from the literature that were either positively or negatively correlated with weight outcomes in previous studies. The diversity of query variables was higher in OSM compared with Google Maps. In each pilot area, query results from Google showed a higher absolute number of true-positive hits and of false-positive hits, but a lower number of false-negative hits during the validation process. The positive predictive value of database hits was higher in OSM and ranged between 81 and 100% compared with a range of 63-89% for Google Maps. In contrast, sensitivities were higher in Google Maps (between 59 and 98%) than in OSM (between 20 and 64%). CONCLUSIONS: It was possible to operationalize obesogenic factors identified from the literature with data and variables available from geocoding services. The validity of Google Maps and OSM was reasonable. The assessment of environmental obesogenic factors via geocoding services could potentially be applied in diabetes surveillance.

Random anti-lasing through coherent perfect absorption in a disordered medium.

Non-Hermitian wave engineering is a recent and fast-moving field that examines both fundamental and application-oriented phenomena1-7. One such phenomenon is coherent perfect absorption8-11-an effect commonly referred to as 'anti-lasing' because it corresponds to the time-reversed process of coherent emission of radiation at the lasing threshold (where all radiation losses are exactly balanced by the optical gain). Coherent perfect absorbers (CPAs) have been experimentally realized in several setups10-18, with the notable exception of a CPA in a disordered medium (a medium without engineered structure). Such a 'random CPA' would be the time-reverse of a 'random laser'19,20, in which light is resonantly enhanced by multiple scattering inside a disorder. Because of the complexity of this scattering process, the light field emitted by a random laser is also spatially complex and not focused like a regular laser beam. Realizing a random CPA (or 'random anti-laser') is therefore challenging because it requires the equivalent of time-reversing such a light field in all its degrees of freedom to create coherent radiation that is perfectly absorbed when impinging on a disordered medium. Here we use microwave technology to build a random anti-laser and demonstrate its ability to absorb suitably engineered incoming radiation fields with near-perfect efficiency. Because our approach to determining these field patterns is based solely on far-field measurements of the scattering properties of a disordered medium, it could be suitable for other applications in which waves need to be perfectly focused, routed or absorbed.

Secondary data in diabetes surveillance - co-operation projects and definition of references on the documented prevalence of diabetes.

In addition to the Robert Koch Institute's health surveys, analyses of secondary data are essential to successfully developing a regular and comprehensive description of the progression of diabetes as part of the Robert Koch Institute's diabetes surveillance. Mainly, this is due to the large sample size and the fact that secondary data are routinely collected, which allows for highly stratified analyses in short time intervals. The fragmented availability of data means that various sources of secondary data are required in order to provide data for the indicators in the four fields of action for diabetes surveillance. Thus, a milestone in the project was to check the suitability of different data sources for their usability and to carry out analyses. Against this backdrop, co-operation projects were specifically funded in the context of diabetes surveillance. This article presents the results that were achieved in co-operation projects between 2016 and 2018 that focused on a range of topics: from evaluating the usability of secondary data to statistically modelling the development of epidemiological indices. Moreover, based on the data of the around 70 million people covered by statutory health insurance, an initial estimate was calculated for the documented prevalence of type 2 diabetes for the years 2010 and 2011. To comparably integrate these prevalences over the years in diabetes surveillance, a reference definition was established with external expertise.

Focusing inside Disordered Media with the Generalized Wigner-Smith Operator.

We introduce a wave front shaping protocol for focusing inside disordered media based on a generalization of the established Wigner-Smith time-delay operator. The key ingredient for our approach is the scattering (or transmission) matrix of the medium and its derivative with respect to the position of the target one aims to focus on. A specific experimental realization in the microwave regime is presented showing that the eigenstates of a corresponding operator are sorted by their focusing strength-ranging from strongly focusing on the designated target to completely bypassing it. Our protocol works without optimization or phase conjugation and we expect it to be particularly attractive for optical imaging in disordered media.

Dynamically encircling an exceptional point for asymmetric mode switching.

Physical systems with loss or gain have resonant modes that decay or grow exponentially with time. Whenever two such modes coalesce both in their resonant frequency and their rate of decay or growth, an 'exceptional point' occurs, giving rise to fascinating phenomena that defy our physical intuition. Particularly intriguing behaviour is predicted to appear when an exceptional point is encircled sufficiently slowly, such as a state-flip or the accumulation of a geometric phase. The topological structure of exceptional points has been experimentally explored, but a full dynamical encircling of such a point and the associated breakdown of adiabaticity have remained out of reach of measurement. Here we demonstrate that a dynamical encircling of an exceptional point is analogous to the scattering through a two-mode waveguide with suitably designed boundaries and losses. We present experimental results from a corresponding waveguide structure that steers incoming waves around an exceptional point during the transmission process. In this way, mode transitions are induced that transform this device into a robust and asymmetric switch between different waveguide modes. This work will enable the exploration of exceptional point physics in system control and state transfer schemes at the crossroads between fundamental research and practical applications.

Microwave experiments simulating quantum search and directed transport in artificial graphene.

A series of quantum search algorithms have been proposed recently providing an algebraic speedup compared to classical search algorithms from N to √N, where N is the number of items in the search space. In particular, devising searches on regular lattices has become popular in extending Grover's original algorithm to spatial searching. Working in a tight-binding setup, it could be demonstrated, theoretically, that a search is possible in the physically relevant dimensions 2 and 3 if the lattice spectrum possesses Dirac points. We present here a proof of principle experiment implementing wave search algorithms and directed wave transport in a graphene lattice arrangement. The idea is based on bringing localized search states into resonance with an extended lattice state in an energy region of low spectral density-namely, at or near the Dirac point. The experiment is implemented using classical waves in a microwave setup containing weakly coupled dielectric resonators placed in a honeycomb arrangement, i.e., artificial graphene. Furthermore, we investigate the scaling behavior experimentally using linear chains.