Risk Factors for Hearing Screen Failure in a Single-Family Room Neonatal Intensive Care Unit.

Objective:  This study aimed to determine hearing screen outcomes and identify clinical and environmental risk factors for hearing screen failure in very preterm infants at a level IV single-family room (SFR) neonatal intensive care unit (NICU).

Study Design:  We conducted a retrospective study of infants <33 weeks gestational age admitted to a level IV SFR NICU who survived to discharge and had automated auditory brainstem response results available. Demographics, antenatal and postnatal factors, and respiratory support modes and their duration were collected from the electronic medical record.

The effect of tethered bi-naphthyls on visible-light promoted alkene-alkene [2 + 2] cycloadditions.

Dispersion interactions are ubiquitous weak interactions that can play a role in many chemical events. Tailor-made catalysts and additives can lead to more selective reactions by properly exploiting dispersion interactions. Although radical-π dispersion interactions are known to have an important stabilizing role, this concept has been so far overlooked in synthetic photochemistry.

Mono-, bi- and tri-metallic Fe-based platinum group metal-free electrocatalysts derived from phthalocyanine for oxygen reduction reaction in alkaline media.

In this manuscript, a comprehensive study is presented on Fe-based electrocatalysts with mono, bi, and tri-metallic compositions, emphasizing the influence of processing-structure correlations on the electrocatalytic activity for the oxygen reduction reaction (ORR) in the alkaline medium. These electrocatalysts were synthesized through the mixing of transition metal phthalocyanines (TM-Pc) with conductive carbon support, followed by controlled thermal treatment at specific temperatures (600 °C and 900 °C). An extensive analysis was conducted, employing various techniques, including X-ray Absorption Spectroscopy (XAS), Transmission Electron Microscopy (TEM), and X-ray Diffraction (XRD), providing valuable insights into the structural characteristics of the synthesized nanoparticles.

Visible-Light-Promoted Tandem Skeletal Rearrangement/Dearomatization of Heteroaryl Enallenes.

Access to complex three-dimensional molecular architectures via dearomatization of ubiquitous aryl rings is a powerful synthetic tool, which faces, however, an inherent challenge to overcome energetic costs due to the loss of aromatic stabilization energy. Photochemical methods that allow one to populate high-energy states can thus be an ideal strategy to accomplish otherwise prohibitive reaction pathways. We present an original dearomative rearrangement of heteroaryl acryloylallenamides that leads to complex fused tricycles.

Secretory-IgA binding to intestinal microbiota attenuates inflammatory reactions as the intestinal barrier of preterm infants matures.

Previous work has shown that Secretory-IgA (SIgA) binding to the intestinal microbiota is variable and may regulate host inflammatory bowel responses. Nevertheless, the impact of the SIgA functional binding to the microbiota remains largely unknown in preterm infants whose immature epithelial barriers make them particularly susceptible to inflammation. Here, we investigated SIgA binding to intestinal microbiota isolated from stools of preterm infants <33 weeks gestation with various levels of intestinal permeability.

Predicting the likelihood of lower respiratory tract infection in preterms.

Objective: To develop predictive models of spp lower airway tract infection in preterm infants.

Methods: A dataset was assembled from five cohorts of infants born <33 weeks gestational age (GA) enrolled over 17 years (1999-2016) with culture and/or PCR-confirmed tracheal aspirate status in the first week of life (n=415). Seventeen demographic, obstetric and neonatal factors were analysed including admission white blood cell (WBC) counts.

Highly Specialized Carbohydrate Metabolism Capability in Strains Associated with Intestinal Barrier Maturation in Early Preterm Infants.

"Leaky gut," or high intestinal barrier permeability, is common in preterm newborns. The role of the microbiota in this process remains largely uncharacterized. We employed both short- and long-read sequencing of the 16S rRNA gene and metagenomes to characterize the intestinal microbiome of a longitudinal cohort of 113 preterm infants born between 24 and 32 weeks of gestation.

Mice Expressing Cosegregating Single Nucleotide Polymorphisms (D298G and N397I) in TLR4 Have Enhanced Responses to House Dust Mite Allergen.

Asthma is a common and ubiquitous chronic respiratory disease that is associated with airway inflammation and hyperreactivity resulting in airway obstruction. It is now accepted that asthma is controlled by a combination of host genetics and environment in a rather complex fashion; however, the link between sensing of the environment and development and exacerbation of allergic lung inflammation is unclear. Human populations expressing cosegregating D299G and T399I polymorphisms in the gene are associated with a decreased risk for asthma in adults along with hyporesponsiveness to inhaled LPS, the TLR4 ligand.

Altered Gut Microbiome and Fecal Immune Phenotype in Early Preterm Infants With Leaky Gut.

Intestinal barrier immaturity, or "leaky gut", is the proximate cause of susceptibility to necrotizing enterocolitis in preterm neonates. Exacerbated intestinal immune responses, gut microbiota dysbiosis, and heightened barrier injury are considered primary triggers of aberrant intestinal maturation in early life. Inordinate host immunity contributes to this process, but the precise elements remain largely uncharacterized, leaving a significant knowledge gap in the biological underpinnings of gut maturation.

Renal versus cerebral saturation trajectories: the perinatal transition in preterm neonates.

Background: The aim of this study was to develop reference renal saturation (rSrO) curves in premature infants, depict how they differ from cerebral saturation (rScO) curves, and evaluate the effect of blood pressure on these values using near-infrared spectroscopy (NIRS).

Methods: This is a prospective cohort study of 57 inborn infants <12 h and <30 weeks gestation. rScO, rSrO, fractional tissue oxygen extraction (FTOE), and mean arterial blood pressure (MAP) were continuously monitored every 30 s for 96 h.

The association between carbon dioxide, cerebral blood flow, and autoregulation in the premature infant.

Objective: Evaluate the association between carbon dioxide (pCO), cerebral blood flow (CBF), and cerebral autoregulation (CA) in preterm infants.

Study Design: Cerebral saturations (rScO surrogate for CBF using NIRS) and mean arterial blood pressure (MAP) monitored for 96 h in infants <29 weeks gestation. Relationship between rScO, the rScO-MAP correlation (CA analysis) and pCO category assessed by mixed effects modeling.

Point-of-Care Ultrasound to Confirm Umbilical Line Placement: Impact of a Simulation Enhanced Curriculum on Neonatal Intensive Care Unit Provider Competency.

Introduction: Neonatal intensive care unit (NICU) provider point-of-care ultrasound (POCUS) procedural competency for umbilical line placement confirmation has not been defined, and the necessary training to achieve competency has not been previously studied. This study's objective was to test the hypothesis that a simulation-enhanced curriculum will improve NICU providers' POCUS competency to confirm umbilical line placement.

Methods: Neonatal intensive care unit providers without prior ultrasound experience were randomized to a curriculum with or without simulation-based training.

Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application.

Objective: This study aimed to determine the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures. We hypothesized that monitoring with a smartphone application would identify modifiable environmental factors in different NICU design formats.

Study Design: Minimum, maximum, and peak decibel (dB) recordings were obtained using the Decibel X phone app, and the presence of noise sources was recorded in each patient space at three NICUs over a 6-month period (December 2017 to May 2018).

Randomised trial of azithromycin to eradicate in preterm infants.

Objective: To test whether azithromycin eradicates from the respiratory tract in preterm infants.

Design: Prospective, phase IIb randomised, double-blind, placebo-controlled trial.

Setting: Seven level III-IV US, academic, neonatal intensive care units (NICUs).

Microbial Biomarkers of Intestinal Barrier Maturation in Preterm Infants.

Intestinal barrier immaturity, or "leaky gut," is the proximate cause of susceptibility to necrotizing enterocolitis in preterm neonates. However, the impact of intestinal microbiota development on intestinal mucosal barrier maturation has not been evaluated in this population. In this study, we investigated a longitudinally sampled cohort of 38 preterm infants < 33 weeks gestation monitored for intestinal permeability (IP) and fecal microbiota during the first 2 weeks of life.

Impact of red blood cell transfusions on intestinal barrier function in preterm infants.

Objective: To determine the relationships of red blood cell (RBC) transfusion and enteral feeding to changes in intestinal permeability (IP) measured by the relative intestinal uptake of lactulose (La) and rhamnose (Rh) in preterm infants <33 wk gestation.

Design/methods: Infants 240-326wk gestation received La/Rh solution enterally on study days 1, 8 and 15.Urinary La/Rh ratio was measured by HPLC.

Cerebral autoregulation in premature infants during the first 96 hours of life and relationship to adverse outcomes.

Objective: To test the hypothesis that impaired cerebral autoregulation (ICA) increases the susceptibility of premature infants to adverse outcomes, we determined the relationship of ICA and cerebral reactivity (CR) measured in the first 96 hours of life to the outcome of grade 3 or 4 intraventricular haemorrhage (IVH) and/or death within 1 month.

Setting: Single-centre level IV neonatal intensive care unit.

Patients: Neonates 24-29 weeks' gestation less than 12 hours old with invasive blood pressure monitoring.

Intestinal Barrier Maturation in Very Low Birthweight Infants: Relationship to Feeding and Antibiotic Exposure.

Objective: To test the hypothesis that feeding and antibiotic exposures affect intestinal barrier maturation in preterm infants, we serially measured intestinal permeability (IP) biomarkers in infants <33 weeks gestation (gestational age [GA]) during the first 2 weeks of life.

Study Design: Eligible infants <33 weeks GA were enrolled within 4 days of birth in a prospective study of IP biomarkers (NCT01756040). Study participants received the nonmetabolized sugars lactulose/rhamnose enterally on study days 1, 8, and 15 and lactulose/rhamnose were measured in urine by high-performance liquid chromatography.

Enhanced allergic responsiveness after early childhood infection with respiratory viruses: Are long-lived alternatively activated macrophages the missing link?

Early childhood infection with respiratory viruses, including human rhinovirus, respiratory syncytial virus (RSV) and influenza, is associated with an increased risk of allergic asthma and severe exacerbation of ongoing disease. Despite the long recognition of this relationship, the mechanism linking viral infection and later susceptibility to allergic lung inflammation is still poorly understood. We discuss the literature and provide new evidence demonstrating that these viruses induce the alternative activation of macrophages.

The Objective Use of Pulse Oximetry to Predict Respiratory Support Transition in Preterm Infants: An Observational Pilot Study.

Background: Preterm infants often require some form of respiratory support with supplemental oxygen and are monitored by continuous pulse oximetry (SpO2 ). The study objective was to determine whether the histogram distribution of SpO2 over a 24-h period will predict readiness for weaning respiratory support in preterm infants. We hypothesize that infants with ≥15% of time spent with SpO2 <86% before transitioning from CPAP or high-flow nasal cannula (HFNC) to low-flow nasal cannula, oxyhood, or room air are more likely to fail transitioning.

Role of Ureaplasma Respiratory Tract Colonization in Bronchopulmonary Dysplasia Pathogenesis: Current Concepts and Update.

Respiratory tract colonization with the genital mycoplasma species Ureaplasma parvum and Ureaplasma urealyticum in preterm infants is a significant risk factor for bronchopulmonary dysplasia (BPD). Recent studies of the ureaplasmal genome, animal infection models, and human infants have provided a better understanding of specific virulence factors, pathogen-host interactions, and variability in genetic susceptibility that contribute to chronic infection, inflammation, and altered lung development. This review provides an update on the current evidence supporting a causal role of ureaplasma infection in BPD pathogenesis.

Congenital hypoventilation syndrome and Hirschsprung's disease - Haddad syndrome: A neonatal case presentation.

Congenital central hypoventilation syndrome (CCHS) is an uncommon cause of apnea in the newborn characterized by the occurrence of apnea predominantly during sleep. Haddad syndrome is CCHS with Hirschsprung's disease. We report a newborn with Haddad syndrome that had a family history of spinal muscular atrophy and discuss aspects of CCHS and important considerations in the evaluation of apnea in the term newborn.