Neurodevelopmental outcome of low-risk moderate to late preterm infants at 18 months.

Background: Of the 15 million preterm births that occur worldwide each year, approximately 80% occur between 32 and 36 + 6 weeks gestational age (GA) and are defined as moderate to late preterm (MLP) infants. This percentage substantiates a need for a better understanding of the neurodevelopmental outcome of this group.

Aim: To describe neurodevelopmental outcome at 18 months in a cohort of healthy low-risk MLP infants admitted to the neonatal unit at birth and to compare the neurodevelopmental outcome to that of a healthy term-born infant group.

Deep-spindle: An automated sleep spindle detection system for analysis of infant sleep spindles.

Background: Sleep spindles are an indicator of the development and integrity of the central nervous system in infants. Identifying sleep spindles manually in EEG is time-consuming and typically requires experienced experts. Automated detection of sleep spindles would greatly facilitate this analysis.

Evolution of early cerebral NIRS in hypoxic ischaemic encephalopathy.

Aim: To describe early cerebral oxygenation (cSO ) and fractional tissue oxygen extraction (FTOE) values and their evolution over the first days of life in infants with all grades of hypoxic-ischaemic encephalopathy (HIE) and to determine whether cSO and FTOE measured early (6 and 12 h) can predict short-term outcome.

Methods: Prospective, observational study of cerebral near-infrared spectroscopy (NIRS) in infants >36 weeks' gestation with HIE. Ten one-hour epochs of cSO and FTOE were extracted for each infant over the first 84 h.

An Introduction to Neonatal EEG.

Newborn care has witnessed significant improvements in survival, but ongoing concerns persist about neurodevelopmental outcome. Protecting the newborn brain is the focus of neurocritical care in the intensive care unit. Brain-focused care places emphasis on clinical practices supporting neurodevelopment in conjunction with early detection, diagnosis, and treatment of brain injury.

Biomarkers Obtained by Transcranial Magnetic Stimulation in Neurodevelopmental Disorders.

Transcranial magnetic stimulation (TMS) is a method for focal brain stimulation that is based on the principle of electromagnetic induction where small intracranial electric currents are generated by a powerful fluctuating magnetic field. Over the past three decades, TMS has shown promise in the diagnosis, monitoring, and treatment of neurological and psychiatric disorders in adults. However, the use of TMS in children has been more limited.

Modulation of motor cortical excitability by continuous theta-burst stimulation in adults with autism spectrum disorder.

Objective: To test whether change in motor evoked potential (ΔMEP) induced by continuous theta-burst stimulation (cTBS) of motor cortex (M1) distinguishes adults with autism spectrum disorder (ASD) from neurotypicals, and to explore the contribution of two common polymorphisms related to neuroplasticity.

Methods: 44 adult neurotypical (NT) participants (age 21-65, 34 males) and 19 adults with ASD (age 21-58, 17 males) prospectively underwent M1 cTBS. Their data were combined with previously obtained results from 35 NT and 35 ASD adults.

Random Forest-based Algorithm for Sleep Spindle Detection in Infant EEG.

Sleep spindles are associated with normal brain development, memory consolidation and infant sleep-dependent brain plasticity and can be used by clinicians in the assessment of brain development in infants. Sleep spindles can be detected in EEG, however, identifying sleep spindles in EEG recordings manually is very time-consuming and typically requires highly trained experts. Research on the automatic detection of sleep spindles in infant EEGs has been limited to-date.

Continuous Theta-Burst Stimulation in Children With High-Functioning Autism Spectrum Disorder and Typically Developing Children.

: A neurophysiologic biomarker for autism spectrum disorder (ASD) is highly desirable and can improve diagnosis, monitoring, and assessment of therapeutic response among children with ASD. We investigated the utility of continuous theta-burst stimulation (cTBS) applied to the motor cortex (M1) as a biomarker for children and adolescents with high-functioning (HF) ASD compared to their age- and gender-matched typically developing (TD) controls. We also compared the developmental trajectory of long-term depression- (LTD-) like plasticity in the two groups.

Prospective Study of Routine Heparin Avoidance Hemodialysis in a Tertiary Acute Care Inpatient Practice.

Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015).

Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing.

Putting the 'C' back into continuous renal replacement therapy.

It may seem obvious that continuous renal replacement therapy (CRRT) means that the treatment is truly continuous--administered without interruption on a 24/7 basis. In reality, a number of barriers limit the continuous aspect of CRRT. This article describes how nursing staff of an inpatient dialysis unit in a large Midwestern academic institution identified these barriers and developed and implemented a multifaceted plan to optimize CRRT.

Randomised controlled trial comparing European standard class 1 to class 2 compression stockings for ulcer recurrence and patient compliance.

The aim of this study was to determine the rate of venous ulcer recurrence and the level of compliance in patients wearing European class 1 or class 2 compression stockings. A total of 100 patients with healed venous leg ulcers were recruited, and were randomised to either class 1 (n = 50) or class 2 (n = 50) compression stockings. Follow-up was at 1 week, 3, 6, 9 and 12 months to monitor ulcer recurrence and compliance.

Doctor training and practice of acupuncture: results of a survey.

Rationale, Aims And Objectives: Although courses in acupuncture are increasingly available to doctors, little is known about educational outcomes, or the impact on doctor practices. We sought to characterize doctors who seek acupuncture training, and describe acupuncture practice and referral patterns after training.

Methods: Using a self-administered survey of doctors completing a 300-hour acupuncture course at Harvard Medical School between 2000 and 2005, we obtained information regarding doctor characteristics, reasons for seeking training, subsequent practice and referral patterns, perceived efficacy, and barriers to using acupuncture.

Markedly raised intake of saturated and monounsaturated fatty acids in rats on a high-fat ketogenic diet does not inhibit carbon recycling of 13C-alpha-linolenate.

Under various dietary and physiological conditions, carbon from alpha-linolenic acid (ALA) is extensively recycled into saturated and monounsaturated fatty acids. In this study we investigated whether carbon is still recycled from ALA when a dietary source of saturated and monounsaturated fatty acids is provided in excess. 13C-labeled ALA was given to rats consuming a high-fat ketogenic diet and to rats consuming a low-fat control diet.

Suckling rats actively recycle carbon from alpha-linolenate into newly synthesized lipids even during extreme dietary deficiency of n-3 polyunsaturates.

Docosahexaenoate is usually considered to be the principal endpoint of alpha-linolenate metabolism in mammals. Nevertheless, several studies over the past 30 y have shown that more carbon from alpha-linolenate is recycled into newly synthesized lipids than is used to make docosahexaenoate. Our objective in this study was to assess carbon recycling from alpha-linolenate in suckling rats made deficient in n-3 polyunsaturated fatty acids (PUFA).

Despite transient ketosis, the classic high-fat ketogenic diet induces marked changes in fatty acid metabolism in rats.

In contrast to humans, rats on a high-fat ketogenic diet seem incapable of maintaining plasma beta-hydroxybutyrate above 1 mmol/L for more than a week. Our goal was to determine whether fatty acid metabolism in rats changes despite the absence of sustained ketosis induced by the ketogenic diet. Fatty acid metabolism was assessed as changes in tissue fatty acid profiles and change in 13C-alpha-linolenic acid incorporation into plasma, liver, adipose tissue, and brain lipids.

Lovastatin exacerbates atypical absence seizures with only minimal effects on brain sterols.

AY-9944 (AY) exacerbates chronic recurrent seizures in rats that are analogous to atypical absence epilepsy in humans. The mechanism by which AY affects the slow spike-and-wave discharges associated with these seizures is not known, but is thought to involve inhibition of cholesterol synthesis. We tested the hypothesis that seizures seen with AY are due to significant reduction in brain cholesterol and/or elevated brain 7-dehydrocholesterol by assessing whether three other cholesterol synthesis inhibitors mimic AY seizures in rats.

Why is carbon from some polyunsaturates extensively recycled into lipid synthesis?

We summarize here the evidence indicating that carbon from alpha-linolenate and linoleate is readily recycled into newly synthesized lipids. This pathway consumes the majority of these fatty acids that is not beta-oxidized as a fuel. Docosahexaenoate undergoes less beta-oxidation and carbon recycling than do alpha-linolenate or linoleate, but is it still actively metabolized by this pathway? Among polyunsaturates, arachidonate appears to undergo the least beta-oxidation and carbon recycling, an observation that may help account for the resistance of brain membranes to loss of arachidonate during dietary deficiency of n-6 polyunsaturates.

Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial.

Background: The US Food and Drug Administration (FDA) approved health claims for 2 dietary fibers, beta-glucan (0.75 g/serving) and psyllium (1.78 g/serving), on the assumption that 4 servings/d would reduce cardiovascular disease risk.