Objective: This study aimed to identify and characterize the 100 most cited dental articles on COVID-19. Materials and Methods: We searched the Web of Science core collection database to identify the 100 most-cited dental articles on COVID-19 in the category of ”Dentistry, Oral Surgery and Medicine” on May 09, 2021. Among the included top most cited articles, the following parameters were recorded and analyzed: article title, publication date, authorship, institution and country of origin, journals, with its impact factor and quartile, number of citations, study design, study topic, and level of evidence (LOE). Results: The mean citation count of the 100 most-cited dental articles on COVID-19 was 32.77 (range 4-750). Four papers were cited more than 100 times. The most productive countries were the USA and China. The Sichuan University from China was the most cited institution. Although 521 authors from 32 different countries contributed to the articles, only 28% had international collaborations. The Journal of Dental Research has the most publications (n=10). The most common study type was narrative reviews (n=38) followed by cross-sectional studies (n=26). Of the 100 most-cited articles, 50 were of LOE VII and 32 LOE V. The recent focuses of the articles were saliva, mouth-washes, oral health, and dental education. Conclusion: According to our analysis, the co-authorship network of the studies is not sufficiently strong. Establishing international cooperation between researchers may increase the quality of future research on COVID-19.

The traditional career path from MD Pharmacology to the medical affairs(MA) within pharmaceutical industry is becoming increasingly challenging and competitive. The MA role has evolved from a ‘medical- knowledge-and-support-only’ role to a ‘strategic decision-making, scientific partner’. Traditional MD Pharmacology background and related knowledge are essential but may no longer be sufficient to ensure ‘Day-1-preparedness’ for an MA role. Transitioning from a medical college environment to the corporate environment would become easier if one develops certain additional soft and hard skills as elaborated in this article. The objective of this manuscript is to recommend how to better-equip the MD Pharmacology residents to be a confident, resourceful and successful MA professionalS. We also elucidate on key skill gaps and the suggested approaches to invest the residency time more judiciously to bridge those gaps for developing more industry-ready pharmacologists. A special segment on changes pertaining to COVID-19 pandemic is also included.

Bronchiectasis and pulmonary fibrosis of the surrounding parenchyma can result from recurrent infection and inflammation. A portion of these patients can present with complete destruction of their lung parenchyma, retraction of the chest cavity and concurrent mediastinal shift. In some cases, lung transplantation is the final option once the reduction of lung capacity becomes clinically detrimental. Concerns with mediastinal shift and chest wall retraction may limit the indication of a double lung transplant in these patients. We report the outcomes as well as preoperative and operative management in two patients with significant lung volume reduction and mediastinal shift due to bronchiectasis of the right lung. Both patients underwent sequential double lung transplantation due to lung failure.

Detecting and assessing changes in the hydrological cycle and how it responds to a changing environment is essential for maintaining regional ecological security and restoring damaged ecosystems. The Ebinur Lake basin, an important ecological barrier in the Junggar Basin of Xinjiang, China, has undergone significant changes in recent decades as a result of massive eco-rehabilitation projects and increased anthropogenic factors. To solve the above defects, we separated the study period into three phases based on the heuristic segmentation algorithm：the reference phase (1964-1985) and two impact phases: I (1986-2000) and II (2001-2017). The Variable Infiltration Capacity (VIC) surface models were used to determine the contribution of both human activities and climate change to streamflow along with its components. Based on the VIC model of streamflow splitting, the results showed that surface runoff, baseflow and snowmelt accounted for 20.97%, 60.37% and 23.42% of the annual runoff volume respectively. The differential evolution Markov chain (DEMC) algorithm improved the Nash-Sutcliffe efficiency by 20% over the traditional SCE-UA algorithm, which exceeded 0.6 and reached reliable level. Increases in cropland and forested land were partially contributed by grassland and heathland throughout the study period, While the leaf area index (LAI) of the season of plant growth showed a trend of 0.002 increase per year. Direct human activity was the main factor in the reduction of runoff in impact phase I and indirect human activity in impact phase II, Whereas, in the total impact phase, climate c

Prostate cancer and benign prostatic hyperplasia (BPH) are two common diseases of the prostate gland. Pharmaceutical drugs are widely used to treat BPH, which enhance symptoms but are also accompanied by side effects such as erectile dysfunction, which have a negative impact on quality of life. Prostate cancer, like other cancers, has a wide range of treatment options. The effectiveness of these prostate cancer therapies is determined by the stage of the disease. While the efficacy of prostate cancer therapies varies, erectile dysfunction, incontinence, and a lower quality of life are all common side effects. Diet and lifestyle factors can be helpful in lowering the risk of cancer, according to preliminary evidence from systematic reviews. Lycopene, a carotenoid found in a variety of red-colored fruits and vegetables, has been shown to have powerful antioxidant and pro-oxidant properties. The existing evidence on the use of lycopene as a prostate disease prevention agent is examined in this chapter.

In this article we are going to present a general procedure for inserting a time conformal factor in the general plane symmetric static spacetime, to it non static. The gravitational waves are plane symmetric and non static, therefore this development will help to understand the phenomenon of formation of gravitational waves. We know that the gravitational waves decay with the passage of time. Its mass-energy momentum tensor must depends on time. To get a time dependent mass-energy momentum tensor we have to insert a time dependent conformal factor in plane symmetric static spacetime. For this purpose we use the Noether symmetry equation and obtain a particular time dependent conformal factor without losing the plane symmetry of the said spacetime. We define a theorem in this regard, which will works for all general plane symmetric distributions.

In this research paper, a numerical investigation of effects of Reynolds number and Elastic number, using MATLAB built in bvp4c solver technique has been done on Walter B fluid flow past a vertical channel. The suitable similarity transformation has been adopted to convert the boundary layer governing equations (Partial Differential Equations) into its corresponding solvable ordinary differential equations and these equations are solved using MATLAB bvp4c scheme. The normal and tangential velocity profiles are drawn for various values of parameter such as Reynolds number (Re) and Elastic number (S) and results are analysed graphically. It is perceived that with enhance of Reynolds number as well as Elastic number the normal velocity profile enhances. Further an error analysis has been done by comparing the work with the results obtained from Homotopy Perturbation Method and the comparison is found to be in very good agreement.

Outbreaks of emerging infectious diseases continue to challenge human health. Novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has triggered a global coronavirus pandemic, namely COVID-19. Multiple variants of SARS-CoV-2 virus are circulating and raises question with respect to effectiveness of different lines of treatment such as vaccines and antiviral drugs. To find appropriate prevention/treatment, 21 plant-based ingredients were identified with antiviral properties. We pseudo typed SARS-CoV-2 on a lentiviral vector plasmid and tested the impact of five different herbal formulations in mammalian HEK293T cells. Viral inactivation assay showed that the natural extracts in herb-derived phytoconstituents based formulation, BITS-003 comprising of Bacopa monnieri, Glycyerrhiza glabra, Asparagus racemosus-wild, and Nigella sativa bear strong virucidal properties, inactivating enveloped viruses from 2log10 (or 99%) to >4log10 (or 99.99%). Moreover, bacterial and yeast cells treated with BITS-003 displayed reduced growth. Topical use of formulation as mouthwash/gargle will be effective in reducing symptoms of respiratory viral infections with a potential to decrease viral load in buccal/oral cavity. This may inhibit the coronavirus spreading to the lungs of infected person and at the same time will reduce the risk of viral transmission to other susceptible persons through micro-droplets originating from the oral cavity of the infected person.

African swine fever (ASF) is an acute and highly contagious infectious disease caused by the African swine fever virus (ASFV). Currently, there is no vaccine against ASF worldwide, and no effective treatment measures are available. For this reason, developing a simple, rapid, specific, and sensitive serological detection method for ASFV antibodies is crucial for the prevention and control of ASF. In this study, a 1:1 mixture of gold-labeled p30 and p72 probes was used as the gold-labeled antigen. The p30 and p72 proteins and their monoclonal antibodies were coated on a nitrocellulose membrane (NC) as a test (T) line and control (C) line, respectively. A colloidal-gold dual immunochromatography strip (ICS) for ASFV p30 and p72 protein antibodies was established. The results showed that the colloidal-gold dual ICS could specifically detect ASFV antibodies within 5–10 min. There was no cross-reaction after testing healthy pig serum, porcine reproductive and respiratory syndrome virus (PRRSV), foot-and-mouth disease type A virus (FMDV-A), foot-and-mouth disease type O virus (FMDV-O), porcine circovirus type 2 (PCV-2), and swine fever (CSFV) positive sera. A positive result was obtained only for the positive control, P1. The sensitivity of the test strips was 1:256, which was equivalent to that of commercially available ELISA kits. Their coincidence rate with the two commercial ASFV ELISA antibody detection kits was higher than 98%. The test strips were stably stored at 18–25 °C and 4 °C for 4 and 6 months, respectively. The dual test strips prepared in this study had high sensitivity and specificity and were characterized by rapid detection, simple operation, and easy interpretation of results. Therefore, they are of great significance to diagnose, prevent, and control African swine fever.

Fluorescein sodium (FL) has been widely used in disease diagnosis and surgery. It is a yellow-dye that fluoresces when the light at wavelengths from 400 nm to 490 nm is irradiated, and its fluorescence can be observed with a surgical fluorescence microscope and a long-pass filter. However, even if an advanced microscope is used, it fails to produce a clear fluorescence image. As a result, it is possible that surgeons are experiencing difficulty in distinguishing tumors from blood vessels. Thus, this paper investigated the effects of a long-pass filter on the fluorescence image and discovered characteristics that affect the quality of the image. In this study, 0.0102mM of FL and a near-infrared camera were prepared, and the fluorescence was observed both in the presence and absence of a long-pass filter. By comparing two different types of the image, it was revealed that a filter is a necessary component in fluorescence microscopy as it blocks undesired light. Furthermore, the intensity of fluorescence after passing through a fabricated filter and a conventional filter was measured. It was discovered that a filter that transmitted the more light has higher transmittance (T) and lower power loss (PL) and optical density (OD). Given that an image becomes clearer if a filter transmits more light, it was concluded that a filter with higher T and lower PL and OD would produce a clearer fluorescence image. If this type of a filter is used in surgery, surgeons will be able to more effectively carry out tumor resection.

Poly(3,4-ethylenedioxythiophene) was synthesized in the presence of a phenothiazine derivative (PTZN_C8). The purpose of the research is to determine the influence of the presence of PTZN_C8 on state of order of forming PEDOT chains and analysis of PTZN_C8 release. Synthesis of PEDOT in the presence of a PTZN_C8 by cyclic voltammetry allowed to characterize the resulting polymer films by determining the accumulated charge capacity. Different synthetic protocols were used to obtain layers of PEDOT as a matrix and phenothiazines derivative as a substance which changed structure of material. Layers were investigated by FTIR to identify the presence of compound incorporated during synthesis. The degree of polymerization was calculated to characterize the length of chains. UV-Vis spectra allowed to calculate the releasing curves of PTZN_C8 from PEDOT matrix. Results showed that PEDOT was modified by changing the length of the chains – as the content of the PTZN_C8 was higher the chains were longer.

Background and Purpose Rivaroxaban is emerging as a viable anticoagulant for the pharmacological management of cancer associated venous thromboembolism (CA-VTE). Being eliminated via CYP3A4/2J2-mediated metabolism and organic anion transporter 3 (OAT3)/P-glycoprotein-mediated renal secretion, rivaroxaban is susceptible to drug-drug interactions (DDIs) with protein kinase inhibitors (PKIs), erlotinib and nilotinib. Physiologically based pharmacokinetic (PBPK) modelling was applied to interrogate the DDIs for dose adjustment of rivaroxaban in CA-VTE. Experimental Approach The inhibitory potencies of erlotinib and nilotinib on CYP3A4/2J2-mediated metabolism of rivaroxaban were characterized. Using prototypical OAT3 inhibitor ketoconazole, in vitro OAT3 inhibition assays were optimized to ascertain the in vivo relevance of derived inhibitory constants (Ki). DDIs between rivaroxaban and erlotinib or nilotinib were investigated using iteratively verified PBPK model. Key Results Mechanism-based inactivation (MBI) of CYP3A4-mediated rivaroxaban metabolism by both PKIs and MBI of CYP2J2 by erlotinib were established. The importance of substrate specificity and nonspecific binding to derive OAT3-inhibitory Ki values of ketoconazole and nilotinib for the accurate prediction of DDIs was illustrated. When simulated rivaroxaban exposure variations with concomitant erlotinib and nilotinib therapy were evaluated using published dose-exposure equivalence metrics and bleeding risk analyses, dose reductions from 20 mg to 15 mg and 10 mg in normal and mild renal dysfunction, respectively, were warranted. Conclusion and Implications We established the PBPK-DDI platform to prospectively interrogate and manage clinically relevant interactions between rivaroxaban and PKIs in patients with underlying renal impairment. Rational dose adjustments were proposed, attesting to the capacity of PBPK modelling in facilitating precision medicine.

Approaches using microsatellite markers are considered the gold standard for modern population-genetic studies. However, though they have found application in research into various platyhelminth taxa, they remained substantially underutilized in the study of monogeneans. In the present study, a newly-developed set of 24 microsatellite markers was used to investigate the genetic diversity of the generalist monogenean species D. vistulae. The analyzed parasite specimens were collected from 13 cyprinoid species from 11 sites in the Apennine and Balkan peninsulas. A total of 159 specimens were genotyped at each of the loci and the number of alleles per locus ranged from 2 to 16, with a mean number of 6.958 alleles per locus. Exceptionally high genetic diversity was observed among D. vistulae individuals in the southern Balkans, suggesting that this region might represent the center of diversification of the genus in Europe, from where Dactylogyrus parasites expanded into the north. The initial clustering analysis divided all investigated specimens into three major clusters; however, the results of the subsequent analyses revealed the existence of various subpopulations, suggesting that the population structure of D. vistulae is associated with the diversification of their cyprinoid hosts. In addition, partition of the parasite population was observed in regions of the sympatric occurrence of two host species, indicating that these hosts may represent a barrier to gene flow, even for generalist parasite species.

BACKGROUND: Heart failure (HF) is a clinical syndrome in which the heart cannot pump enough blood for the needs of the human body in terms of life functions. Some biochemical diagnostic tests as well as echocardiography play a role in the early diagnosis of this syndrome. The complex pathophysiology of HF suggests that many other markers may be useful in diagnosis and follow-up. AIM: After many recent studies, it has been suggested that adipokines fetuin-A, omentin-1 and chemerin may be suitable biomarkers for the diagnosis of HF. Our main aim in this study is to determine the relationship between fetuin-A, omentin-1 and chemerin levels with HF clinical classification. METHOD: The patients admitted to the cardiology service with symptomatic HF with heart failure with preserved ejection fraction (HF-pEF, n=62), heart failure with reduced EF (HF-rEF, n=61) and heart failure with mid-range EF (HF-mrEF, n=63) were included in the study. A total of 246 participants were evaluated by taking the control group (n=60) for comparison. The main characteristics of all groups were recorded and serum levels of fetuin-A, omentin-1 and chemerin were evaluated. RESULTS: When compared with the control group, there was a significant difference for fetuin-A with the HF-rEF group [452.3 (441.4-528.9); 555.3 (453.7-615.6) p<0.001, respectively]. When evaluating for omentin-1, there was a significant difference between the control group and HF-rEF [19.3 (16.9-22.7); 22.9 (16.8-29.7) p<0.001, respectively]. However, there was no significant difference for chemerin between the HF groups and the control group. Significant cut-off value for fetuin-A was found to be 485 in ROC analysis (AUC: 0.74 sens: 0.72 (95% CI: 0.57-0.82), spec: 0.69 (95% CI: 0.59-0.83), p<0.001). CONCLUSION: Serum fetuin-A levels were found to be increased in HF, especially in the HF-rEF group and it can be used in the diagnosis of this patient group.

Pseudomonas aeruginosa (PA) is an electrogenic bacterium, in which extracellular electron transfer (EET) is mediated by microbially-produced phenazines, especially pyocyanin. Increasing EET rate in electrogenic bacteria is key for the development of biosensors and bioelectrofermentation processes. In this work, the production of pyocyanin and Nicotinamide Adenine Dinucleotide (NAD) synthetase in the electrogenic strain PA-A4 is determined in microbial fuel cells (MFCs). The MFC potentials correlates with the NAD synthetase activity and with pyocyanin production. With the fusion and combined overexpression of nicotinic acid mononucleotide adenyltransferase (nadD) and quinolic acid phosphoribosyltransferase (nadC) genes, which are distant on the PA genomic map, faster co-transcription and increased NAD synthetase activity is enabled. The resulting PA-A4 nadD+nadC shows both increased pyocyanin concentration and MFC potential than the unmodified strain. Extracellular respiratory mechanisms in PA are linked with NAD metabolism, and targeted increased yield of NAD could directly lead to enhanced EET. However, this is the first report of electrogenicity enhancement in PA by fusion and combined overexpression of nadD and nadC genes.

Objective: The objective of this study was to examine Irish obstetrics and gynaecology trainees’ experiences with and opinions of termination of pregnancy (ToP) after legal change. Design: this is a cross-sectional web-based survey study. Setting: Republic of Ireland. Population: We invited obstetrics & gynaecology non-consultant hospital doctors (NCHDs) to participate in a web-based survey through a professional e-mail listserv. Methods: We conducted descriptive statistical analyses of responses using Stata SE Version 16. Main outcome measures: Irish NCHDs’ reported future willingness to provide ToP. Results: A total of 102/202 (50.5%) trainees responded to the survey. Of these, 61.8% believe that ToP should be allowed on request up to 12 weeks and in limited circumstances thereafter (in line with current Irish law), and 19.6% believe ToP should be allowed on request even after 12 weeks. Knowledge about the abortion law was high (70.6% achieved a perfect knowledge score). Since the new law came into effect, 61.8% of trainees reported having participated in abortion care, though only 25.5% have performed surgical procedures. More than 75% of respondents would like to receive more training in all clinical skills related to ToP (early pregnancy ultrasound, first and second trimester medical and surgical abortion). In the future, 67.6% of respondents would be willing to provide TOP in all circumstances allowed by law. Conclusions: Irish obstetrics & gynaecology trainees are generally supportive of the legislation. Few trainees have performed surgical abortions, and most would like to receive additional training in clinical skills related to abortion care.

Resources critical for successful breeding are typically partition in nature. To increase reproductive fitness, females may associate with males who provide access to high quality resources while mating other males with good or compatible genes. Gibbons have traditionally been described as living in small monogamous groups and the sole resident adult male is assumed to sire all of the group’s offspring. Based on 16 years of field observations and microsatellite analyses, we describe the social system and reproductive strategies of a population of Nomascus concolor in the Wuliang Mountains, China. From 2003 to 2018, each of our three study groups consisted one resident male and two breeding females across 98.4% of observation months. Resident males spent 2.3 - 5.6% time (N = 7 pairs) within 1 m of both females in their group, comparable to monogamous gibbon groups. Weakened bond strength predicted male/female replacement in two groups. However, microsatellite analyses revealed that the rate of extra-group paternity (EGP) was 40.0% (N = 15), considerably greater than reported for monogamous gibbon species (0 - 10%). Females engaged in EGP to increase offspring heterozygosity. Resident males seem unable to monopolize the mating activities of females, floater males had reproductive success (N = 2). Our findings indicate that in crested gibbons the social system is distinct from the breeding system. Our study also highlights again that long-term continuous field work and non-invasive genetic analysis are essential for understanding breeding systems of long-lived mammals.

Understanding genomic bases of environmental adaptation is central to evolutionary biology and important for assessing adaptive potential of organisms under rapid climate change. Climate change is causing profound changes in world’s ocean, and genomic studies on keystone marine species such as the estuarine oyster (Crassostrea ariakensis) may inform how marine ecosystems respond to environmental shifts. We constructed a chromosome-level assembly of the estuarine oyster genome that spans 613.89 Mb and encodes 29,631 proteins. Resequencing of 264 wild individuals across wide latitude distribution revealed remarkably low genomic diversity in the estuarine oyster compared with its sister species and fine population structures shaped by historical glaciation, geological events and oceanographic forces. Genes from regions under selection were mostly involved in responding to temperature and salinity stress, demonstrating selection by these two environmental factors is a strong evolutionary force. Genes under selection included a large cluster of tandemly duplicated members of the solute carrier membrane transport protein families which are also expanded in two other low-salinity oyster species, highlighting the significance of membrane transporter expansion in estuarine adaptation. Genes exhibiting high plasticity showed strong selection in upstream regulatory regions that modulate transcription, indicating selection favoring plasticity. This study revealed genomic signatures of past glaciation and fine population structures shaped by climate history, physical forces and selection in a bivalve mollusc. Our results show gene expansion and selection in regulatory regions enhance phenotypic plasticity that is critical for organisms to survive and adapt to rapidly changing environments.

Background: Understanding middle ear anatomy, in addition to endoscopic surgical skill acquisition, is an arduous task. Mastering 3-dimensional conceptualization as well as surgical dexterity may take many years. The coronavirus pandemic has made training difficult and complicated due to social distancing and risk of aerosolized viral spread in cadaver dissection. Objectives: We suggest a smartphone-based endoscope ovine head cadaveric dissection which is a simple, safe, and affordable training model for residents as an initial step in otologic endoscopic surgery training. Design: A stepwise depiction of endoscopic ovine middle ear surgery; from cadaver and equipment acquisition, setting preparation, to surgical explanation and procedural steps. Results: Smartphone-based endoscopic otological ovine dissections provide comprehensive anatomical understanding, middle ear proprioception, as well as a “safe” practicing model for diverse middle ear procedures for the novice endoscopic surgeon. Conclusions: The ovine cadaver otological smartphone-based endoscopic surgery training model is an affordable, easy, reproducible, and transportable model, which makes it an ideal model from implementation in both low-middle and high-income countries.

Title: Sudden QRS widening while ablating a concealed left accessory pathway during left ventricular pacing

Porcine epidemic diarrhea virus (PEDV), an enteric coronavirus, has become the major causative agent of acute gastroenteritis in piglets since 2010 in China. Given a raised interest in the mutation and recombination of viral genomes, the genetic and antigenic characteristics of PEDV should be continuously investigated. In the current study, 91 complete spike (S) gene sequences were obtained from PEDV positive samples collected from17 provinces in China from March 2020 to March 2021. A phylogenetic analysis showed that 92.3% (84 out of 91) of the identified strains belonged to GII subtype, while 7.7 % (7 out of 91) were categorized as S-INDEL like strains and grouped within GI-c clade. Based on a recombination analysis, six of S-INDEL like strains were recombinant strains originated from S-INDEL strain FR/001/2014 and vaccine strain AJ1102. In addition, PEDV variant strains carrying novel insertions (360QGRKS364 and 1278VDVF1281) in the S protein were observed. Furthermore, the deduced amino acid sequences analysis for the S protein showed that multiple amino acid substitutions in the neutralizing domain (COE) and three neutralizing epitopes (S1 A, SS6, 2C10) were found as compared with the vaccine strains (CV777 and AJ1102). The recombination of field and vaccine strains, along with variation of antigenic epitopes, might affect the virulence and antigenicity of PEDV, thus resulting in a failure of immunization. In conclusion, these data provide novel molecular evidences on the epidemiology and molecular diversity of PEDV in 2020–2021. This information may help design a strategy for controlling and preventing the prevalence of PEDV variant strains in China.

In this paper, the barycentric Lagrange interpolation iteration method is proposed to solve the extended FisherKolmogorov equation. Direct linearized iterative method, partial linearized iterative method and Newton linearized iterative method are introduced to deal with the nonlinear term of the equation. Then the nonlinear equation is transformed into a linear equation to solve the extended Fisher-Kolmogorov equation. The unknown function is approximated by barycentric Lagrange interpolation basis function, and the differential matrix form is obtained from iterative scheme. By combining the equation with the initial and boundary conditions, the numerical solution of the equation can be solved iteratively. Finally, the convergence analysis of the barycentric Lagrange interpolation iteration method is given, and numerical examples show that the proposed method is convergent and has higher numerical accuracy.

In this paper, we consider the existence of positive solutions of second order q-difference boundary value problem D^2_q y(t) + λ f(t,y(t)),~~ a < t < b, with boundary conditions α y(a) - β D_q y(a)=0,\\ γ y(b) + δ D_q y(b)=0, where λ>0. An attempt has been to establish the existence of a positive solution to the above boundary value problem. Here, we are using fixed point theorems in a cone to obtain the existence of the positive solution of the above q-difference boundary value problem, when f(t, y) is superlinear. This is the new approach to establish the existence of a positive solution of q-difference equations.

Objective: To compare maternal and infant outcomes with different antihypertensive medications in pregnancy Design: Retrospective cohort study Setting: Kaiser Permanente, a large US healthcare system. Population: Women aged 15-49 years with a singleton birth from 2005-2014 treated for hypertension. Methods: We identified medication exposure from automated pharmacy data based on the earliest dispensing after the first prenatal visit. Using logistic regression, we calculated weighted outcome prevalences, adjusted odds ratios (aORs) and 95% confidence intervals, with inverse probability of treatment weighting to address confounding. Main outcome measures: Small for gestational age (SGA), preterm delivery, neonatal and maternal intensive care unit (ICU) admission, preeclampsia, and stillbirth or termination at > 20 weeks. Results: Among 6346 deliveries, 87% with chronic hypertension, the risk of SGA (birthweight < 10th percentile) was lower with methyldopa than labetalol (prevalence 13.6% vs. 16.6%; aOR 0.77, 95% CI 0.63 to 0.92). For birthweight < 3rd percentile the aOR was 0.57 (0.39 to 0.80). Compared with labetalol (26.0%), risk of preterm delivery was similar for methyldopa (26.5%; aOR 1.10 [0.95 to 1.27]) and slightly higher for nifedipine (28.5%; aOR 1.25 [1.06 to 1.46]) and other β-blockers (31.2%; aOR 1.58 [1.07 to 2.23]). NICU admission was more common with nifedipine than labetalol (25.9% vs. 23.3%, aOR 1.21 [1.02 to 1.43]) but not elevated with methyldopa. Risks of other outcomes did not differ by medication. Conclusions: Risk of most outcomes was similar comparing labetalol, methyldopa and nifedipine. SGA risk was substantially lower for methyldopa, suggesting this medication may warrant further consideration.