Hyperglycemia as a risk factor for the development of retinopathy of prematurity

BACKGROUND: Hyperglycemia has recently been described as a risk factor for the development of retinopathy of prematurity (ROP), a proliferative vascular disease of the retina that primarily affects premature infants. This study was to evaluate the relationship of hyperglycemia and the development of ROP in premature infants less than 32 weeks gestation. METHODS: This was a retrospective cohort study of all infants less than 32 weeks gestation from 2003–2007 who survived to discharge in our NICU. Demographic data including birthweight, gestational age, Apgar scores, method of delivery, antenatal steroid use, neonatal steroid use, and size for gestational age was collected for each infant. Episodes of sepsis, grade of intraventricular hemorrhage, presence of a patent ductus arteriosus, number of days on the ventilator, and stage of necrotizing enterocolitis were assessed as well as days of hyperglycemia, defined as number of days with whole blood glucose > 150 mg/dl. In addition, the highest stage of ROP was recorded for each infant. A Student’s two tailed t-test or Fisher’s exact test was performed to identify significant clinical risk factors associated with the development of ROP. From this univariate analysis, a multiple logistic regression was performed to determine the effect of hyperglycemia on the development of ROP, adjusting for significant clinical risk factors. Statistical analysis was performed using SAS v.9.2. RESULTS: Univariate analysis demonstrated that infants with ROP were of lower birthweight and gestational age, and were affected by a patent ductus arteriosus, neonatal sepsis, intraventricular hemorrhage, have significant lung disease and received postnatal glucocorticoid therapy. Infants with ROP experienced more days with hyperglycemia (7 vs. 2, p = < 0.0001). Using multiple logistic regression analysis to compare no ROP vs. all stages of ROP, gestational age (OR 0.745, 95% CI [0.634, 0.877], p = 0.0004), mean days of hyperglycemia (OR 1.073, 95% CI [1.004, 1.146], p = 0.04), and mean days receiving mechanical ventilation (OR 1.012, 95% CI [1.000, 1.025], p = 0.05) remained significantly associated with ROP after adjusting for other risk factors. CONCLUSION: Our data suggests that hyperglycemia is associated with the development of ROP in premature infants

Heating-Rate-Coupled Model for Hydrogen Reduction of JSC-1A

A previously developed and validated model for hydrogen reduction of JSC-1A for a constant reaction-bed temperature is extended to account for reaction during the bed heat-up period. A quasisteady approximation is used wherein an expression is derived for a single average temperature of reaction during the heat-up process by employing an Arrhenius expression for regolith conversion. Subsequently, the regolith conversion during the heat-up period is obtained by using this representative temperature. Accounting for the reaction during heat-up provides a better estimate of the reaction time needed at the desired regolith-bed operating temperature. Implications for the efficiency of the process, as measured by the energy required per unit mass of oxygen produced, are also indicated

Introduction to Resilient Networks Minitrack

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A case for the resuscitation of infants born at less than 24 weeks gestation

Despite improvements in survival of extremely preterm infants, the decision whether to begin intensive care for infants at borderline viability is controversial. A great deal of this controversy focuses on concerns of survival, cost and neurodevelopmental outcome. Why are these concerns more emphasized in discussions of prematurity than other areas of medicine

A Study of the Impact of Reduced Inertia in Power Systems

Inertia in power systems plays an important role in maintaining the stability and reliability of the system by counteracting changes in frequency. However, the traditional sources of synchronous generation are being displaced by renewable resources, which often have no inherent inertia. This paper investigates the impact of reduced system inertia on several aspects of the dynamic stability of power systems, such as angular stability, primary frequency response, and oscillatory modes. This study is performed on a large-scale 2000 bus synthetic Texas model by selectively replacing synchronous generators with inverter-based generation resources. This paper also compares the analysis results obtained by the above-mentioned inertia-reduction approach of renewable integration with another approach in which the inertia constant of all synchronous generators is decreased. This paper demonstrates that only reducing the inertia of all synchronous generators in a system does not provide an accurate analysis of the challenges associated with the reduced system inertia caused by renewable integration

PdZnAl Catalysts for the Reactions of Water-Gas-Shift, Methanol Steam Reforming, and Reverse-Water-Gas-Shift

Pd/ZnO/Al2O3 catalysts were studied for water-gas-shift (WGS), methanol steam reforming, and reverse-water-gas-shift (RWGS) reactions. WGS activity was found to be dependent on the Pd:Zn ratio with a maximum activity obtained at approximately 0.50, which was comparable to that of a commercial Pt-based catalyst. The catalyst stability was demonstrated for 100 hours time-on-stream at a temperature of 360ºC without evidence of metal sintering. WGS reaction rates were approximately 1st order with respect to CO concentration, and kinetic parameters were determined to be Ea = 58.3 kJ mol-1 and k0 = 6.1x107 min-1. During methanol steam reforming, the CO selectivities were observed to be lower than the calculated equilibrium values over a range of temperatures and steam/carbon ratios studied while the reaction rate constants were approximately of the same magnitude for both WGS and methanol steam reforming. These results indicate that although Pd/ZnO/Al2O3 are active WGS catalysts, WGS is not involved in methanol steam reforming. RWGS rate constants are on the order of about 20 times lower than that of methanol steam reforming, suggesting that RWGS reaction could be one of the sources for small amount of CO formation in methanol steam reforming