Publications by authors named "Thomas R Wood"

Importance: Outcomes after hypoxic-ischemic encephalopathy (HIE) are variable. Predicting death or severe neurodevelopmental impairment (NDI) in affected neonates is crucial for guiding management and parent communication.

Objective: To predict death or severe NDI in neonates who receive hypothermia for HIE.

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  • Multiple-particle tracking (MPT) is a microscopy technique that enables the tracking of many nanoparticles in biological samples, especially useful for studying the brain's extracellular space (ECS).
  • This study develops a machine learning pipeline to analyze changes in the ECS after injury, validating its effectiveness on various MPT data sets through high accuracy in predicting biological age and region differences.
  • The machine learning approach identifies injury states linked to different exposure times, showing improved predictive capabilities and uncovering nonlinear relationships in nanoparticle diffusion not captured by traditional methods.
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  • Increased levels of low-density lipoprotein cholesterol (LDL-C) were observed in individuals following ketogenic diets, particularly in those with a specific "lean mass hyper-responder" (LMHR) phenotype.
  • The study aimed to compare coronary plaque burden in LMHR individuals with high LDL-C (≥190 mg/dL) against matched controls from the Miami Heart cohort.
  • Results showed no significant difference in coronary plaque levels between the ketogenic diet group and controls, indicating that high LDL-C does not correlate with increased coronary plaque burden in metabolically healthy individuals.
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Traumatic brain injuries (TBIs) constitute a significant public health issue and a major source of disability and death in the United States and worldwide. TBIs are strongly associated with high morbidity and mortality rates, resulting in a host of negative health outcomes and long-term complications and placing a heavy financial burden on healthcare systems. One promising avenue for the prevention and treatment of brain injuries is the design of TBI-specific supplementation and dietary protocols centred around nutraceuticals and biochemical compounds whose mechanisms of action have been shown to interfere with, and potentially alleviate, some of the neurophysiological processes triggered by TBI.

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Historically, neonatal neuroscience boasted a robust and successful preclinical pipeline for therapeutic interventions, in particular for the treatment of hypoxic-ischemic encephalopathy (HIE). However, since the successful translation of therapeutic hypothermia (TH), several high-profile failures of promising adjunctive therapies, in addition to the lack of benefit of TH in lower resource settings, have brought to light critical issues in that same pipeline. Using recent data from clinical trials of erythropoietin as an example, the authors highlight several key challenges facing preclinical neonatal neuroscience for HIE therapeutic development and propose key areas where model development and collaboration across the field in general can ensure ongoing success in treatment development for HIE worldwide.

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Dementia, particularly Alzheimer's Disease (AD), has links to several modifiable risk factors, especially physical inactivity. When considering the relationship between physcial activity and dementia risk, cognitive benefits are generally attributed to aerobic exercise, with resistance exercise (RE) receiving less attention. This review aims to address this gap by evaluating the impact of RE on brain structures and cognitive deficits associated with AD.

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Objective: Despite strong evidence for its utility in clinical management and diagnosis of intracranial hemorrhage (ICH), the use of neonatal cranial point-of-care ultrasound (POCUS) has not been standardized in neonatal intensive care units (NICUs) in the United States. The primary aim of this study was to evaluate the feasibility of training NICU providers to perform cranial POCUS by tracking the quality of image acquisition following training.

Methods: Observational single-center cohort study of cranial POCUS images obtained by trained neonatal practitioners (attendings, fellows, and advanced practice providers) using a protocol developed by a radiologist and neonatologist.

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  • The study aimed to compare outcomes in infants with hypoxic-ischemic encephalopathy (HIE) treated with whole-body therapeutic hypothermia (TH) using esophageal vs rectal temperature monitoring.
  • Of the 500 infants analyzed, there were no significant differences in rates of death or neurodevelopmental impairment (NDI) between the two monitoring methods.
  • However, infants monitored rectally had lower odds of experiencing overcooling and hypotension compared to those monitored esophageally, indicating potential benefits of rectal monitoring.*
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Importance: Infants born extremely preterm receive transfusions at higher platelet count thresholds than older children and adults due to concerns for intracranial hemorrhage. A recent randomized trial comparing 2 platelet transfusion thresholds showed the higher threshold was associated with increased risk of long-term adverse neurodevelopmental outcomes.

Objective: To evaluate the association of platelet transfusion exposure with death and severe neurodevelopmental impairment (NDI) at 2 years' corrected age in a cohort of infants born extremely preterm.

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Objective: Determine association between time to regain birthweight and 2-year neurodevelopment among extremely preterm (EP) newborns.

Study Design: Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial evaluating time to regain birthweight, time from birth to weight nadir, time from nadir to regain birthweight, and cumulative weight loss with 2-year corrected Bayley Scales of Infant and Toddler Development 3rd edition.

Results: Among n = 654 EP neonates, those with shorter nadir-to-regain had lower cognitive scores (≤1 day versus ≥8 days: -5.

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Background: Associations of 2-year neurodevelopmental and behavioral outcomes with growth trajectories of preterm infants are unknown.

Methods: This secondary analysis of a preterm cohort examined in-hospital and discharge to 2-year changes in anthropometric z-scores. Two-year follow-up included Bayley Scales of Infant Development (BSID-III) and Child Behavior Checklist.

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Objective: To study the association between the Sarnat exam (SE) performed before and after therapeutic hypothermia (TH) and outcomes at 2 years in infants with moderate or severe hypoxic-ischaemic encephalopathy (HIE).

Design: Secondary analysis of the igh-dose rythropoietin for sphyxia and Encephaopathy Trial. Adjusted ORs (aORs) for death or neurodevelopmental impairment (NDI) based on SE severity category and change in category were constructed, adjusting for sedation at time of exam.

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  • The study aimed to investigate whether the time it takes for infants with hypoxic-ischemic encephalopathy (HIE) to reach a target temperature affects their risk of death or neurodevelopmental impairment (NDI) by the age of 2.
  • It involved 500 infants treated with therapeutic hypothermia, categorizing them into early (≤4 hours) and late (>4 hours) target temperature groups, but results showed no significant differences in mortality or NDI between the two groups.
  • Ultimately, the findings suggest that the timing of reaching target temperature does not independently impact outcomes, as both groups had similar neurodevelopmental scores among survivors.
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  • - Neonatal encephalopathy (NE) is a significant issue in infant health, often resulting from hypoxia-ischemia, which can lead to brain injuries affecting areas like the basal ganglia and thalamus.
  • - In this study, ferrets were subjected to a hypoxia-ischemia/hyperoxia protocol, and researchers measured their rectal temperature one hour post-injury to see if it could indicate the extent of brain damage.
  • - The findings revealed that ferrets who developed spontaneous hypothermia had worse long-term neurological outcomes, suggesting that early temperature readings might serve as an important marker for predicting injury severity in neonatal brain injury contexts.
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  • This study explored the link between blood glucose levels in the first 12 hours after birth and outcomes in infants with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia.
  • Researchers analyzed data from 491 neonates, categorizing their blood glucose levels into hyperglycemia, euglycemia, and hypoglycemia, and examined the association with death or neurodevelopmental impairment (NDI) at 22 to 36 months.
  • Findings showed that euglycemia was more common in moderate HIE, while severe HIE had higher rates of hyperglycemia; both hypo- and hyperglycemia were linked to increased risks of death and NDI compared to euglycemic infants
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Background And Objectives: Intraventricular hemorrhage prevention bundles (IVHPBs) can decrease the incidence of intraventricular hemorrhage (IVH) in premature infants. Our center had a high rate of severe (grade III/IV) IVH (9.8%), and poor adherence (24%) to an IVHPB in neonates born ≤1250 g or ≤30 gestational weeks.

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Ketone bodies such as beta-hydroxybutyrate (BHB) have pleiotropic functional benefits as fuel and signaling metabolites and may have multiple clinical applications. An alternative to inducing ketosis by dietary modification is intravenous delivery of exogenous sources of ketones. It is unknown whether there is a strong relationship between BHB infusion rate and blood BHB concentrations in the published literature; this information is vital for clinical studies investigating therapeutic effects of ketosis.

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Objective: To characterize the presentation and evaluation of infants with neonatal encephalopathy (NE) not due to hypoxic-ischemic encephalopathy (non-HIE NE) and to describe the genetic abnormalities identified.

Study Design: Retrospective cohort study of 193 non-HIE NE neonates admitted to a level IV NICU from 2015 through 2019. For changes in testing over time, Cochrane-Armitage test for trend was used with a Bonferroni-corrected P-value, and comparison between groups was performed using Fisher exact test.

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Background: Neonatal intraventricular hemorrhage prevention bundles for preterm infants commonly defer daily weighing for the first 72 h, with reweighing occurring on day 4. Clinicians rely on maintaining stable sodium values as a proxy of fluid status to inform fluid management decisions over the first 96 h after birth. Yet, there exists a paucity of research evaluating whether serum sodium or osmolality are appropriate proxies for weight loss and whether increasing variability in sodium or osmolality during this early transitional period is associated with adverse in-hospital outcomes.

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Background: Cerebral near-infrared spectroscopy is a non-invasive tool used to measure regional cerebral tissue oxygenation (rScO) initially validated in adult and pediatric populations. Preterm neonates, vulnerable to neurologic injury, are attractive candidates for NIRS monitoring; however, normative data and the brain regions measured by the current technology have not yet been established for this population.

Methods: This study's aim was to analyze continuous rScO readings within the first 6-72 h after birth in 60 neonates without intracerebral hemorrhage born at ≤1250 g and/or ≤30 weeks' gestational age (GA) to better understand the role of head circumference (HC) and brain regions measured.

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Infections remain a leading cause of neonatal death, especially among the extremely preterm infants. To evaluate the incidence, pathogenesis, and in-hospital outcomes associated with sepsis among hospitalized extremely preterm infants born at 24-0/7 to 27-6/7 weeks of gestation, we designed a post hoc analysis of data collected prospectively during the Preterm Epo Neuroprotection (PENUT) Trial, NCT #01378273. We analyzed culture positive infection data, as well as type and duration of antibiotic course and described their association with in-hospital morbidities and mortality.

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Background: Stimulating infants to elicit a cry at birth is common but could result in unnecessary handling. We evaluated heart rate in infants who were crying versus non-crying but breathing immediately after birth.

Methods: This was single-centre observational study of singleton, vaginally born infants at ≥33 weeks of gestation.

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Few reliable or easily obtainable biomarkers to predict long-term outcome in infants with hypoxic-ischemic encephalopathy (HIE) have been identified. We previously showed that mattress temperature (MT), as proxy for disturbed temperature regulation during therapeutic hypothermia (TH), predicts injury on early MRI and holds promise as physiologic biomarker. To determine whether MT in neonates treated with TH for moderate-severe HIE is associated with long-term outcome at 18-22 months, we performed a secondary analysis of the Optimizing Cooling trial using MT data from 167 infants treated at a core temperature of 33.

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Rodent models of neonatal hypoxic-ischemic (HI) injury require a subset of animals to be immobilized for continuous temperature monitoring during the insult and subsequent treatment. Restrained animals are discarded from the analysis due to the effect of restraint on the brain injury as first demonstrated by Thoresen et al 1996. However, the effects of restraint on responses to hypothermic (HT) post-insult therapy are not well described.

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