Patterns of Distress in African American Mothers of Preterm Infants

Objective: To examine inter-relationships among stress due to infant appearance and behavior in the NICU, parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African American mothers of preterm infants and to determine whether there were sub-groups of mothers based on patterns of psychological distress. Method: 177 African American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term. Results: Psychological distress measures were inter-correlated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and post-traumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values. Conclusion: Although different types of maternal psychological distress were substantially related, there were distinct sub-groups of mothers that were identifiable in the NICU. Moreover, these sub-groups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term. Originally published Journal of Developmental and Behavioral Pediatrics, Vol. 30, No. 3, June 200

Effects of Secondhand Smoke Exposure on the Health and Development of African American Premature Infants

Objective. To explore the effects of secondhand smoke exposure on growth, health-related illness, and child development in rural African American premature infants through 24 months corrected age. Method. 171 premature infants (72 boys, 99 girls) of African American mothers with a mean birthweight of 1114 grams. Mothers reported on household smoking and infant health at 2, 6, 12, 18, and 24 months corrected age. Infant growth was measured at 6, 12, 18, and 24 months, and developmental assessments were conducted at 12 and 24 months. Results. Thirty percent of infants were exposed to secondhand smoke within their first 2 years of life. Secondhand smoke exposure was associated with poorer growth of head circumference and the development of otitis media at 2 months corrected age. Height, weight, wheezing, and child development were not related to secondhand smoke exposure. Conclusion. Exposure to secondhand smoke may negatively impact health of rural African American premature infants. Interventions targeted at reducing exposure could potentially improve infant outcomes

Non-Abelian topological defects and strain mapping in 2D moir\'e materials

We present a general method to analyze the topological nature of the domain boundary connectivity that appeared in relaxed moir\'e superlattice patterns at the interface of 2-dimensional (2D) van der Waals (vdW) materials. At large enough moir\'e lengths, all moir\'e systems relax into commensurated 2D domains separated by networks of dislocation lines. The nodes of the 2D dislocation line network can be considered as vortex-like topological defects. We find that a simple analogy to common topological systems with an $S^1$ order parameter, such as a superconductor or planar ferromagnet, cannot correctly capture the topological nature of these defects. For example, in twisted bilayer graphene, the order parameter space for the relaxed moir\'e system is homotopy equivalent to a punctured torus. Here, the nodes of the 2D dislocation network can be characterized as elements of the fundamental group of the punctured torus, the free group on two generators, endowing these network nodes with non-Abelian properties. Extending this analysis to consider moir\'e patterns generated from any relative strain, we find that antivortices occur in the presence of anisotropic heterostrain, such as shear or anisotropic expansion, while arrays of vortices appear under twist or isotropic expansion between vdW materials. Experimentally, utilizing the dark field imaging capability of transmission electron microscopy (TEM), we demonstrate the existence of vortex and antivortex pair formation in a moir\'e system, caused by competition between different types of heterostrains in the vdW interfaces. We also present a methodology for mapping the underlying heterostrain of a moir\'e structure from experimental TEM data, which provides a quantitative relation between the various components of heterostrain and vortex-antivortex density in moir\'e systems.Comment: 15 pages with 11 figure

Exploring Modifiable Risk Factors for Wheezing in African American Premature Infants

To examine the degree to which obesity during infancy, consistent exposure to secondhand smoke, and parenting (positive attention, maternal involvement, and negative control) were related to early development of wheezing in a cohort of African American premature infants at 2, 6, 12, 18, and 24 months corrected age

Patterns of Distress in African-American Mothers of Preterm Infants

To examine inter-relationships among stress due to infant appearance and behavior in the NICU, parental role alteration stress in the NICU, depressive symptoms, state anxiety, post-traumatic stress symptoms, and daily hassles exhibited by African American mothers of preterm infants and to determine whether there were sub-groups of mothers based on patterns of psychological distress

Elevated Endogenous Erythropoietin Concentrations Are Associated with Increased Risk of Brain Damage in Extremely Preterm Neonates

Background We sought to determine, in very preterm infants, whether elevated perinatal erythropoietin (EPO) concentrations are associated with increased risks of indicators of brain damage, and whether this risk differs by the co-occurrence or absence of intermittent or sustained systemic inflammation (ISSI). Methods Protein concentrations were measured in blood collected from 786 infants born before the 28th week of gestation. EPO was measured on postnatal day 14, and 25 inflammation-related proteins were measured weekly during the first 2 postnatal weeks. We defined ISSI as a concentration in the top quartile of each of 25 inflammation-related proteins on two separate days a week apart. Hypererythropoietinemia (hyperEPO) was defined as the highest quartile for gestational age on postnatal day 14. Using logistic regression and multinomial logistic regression models, we compared risks of brain damage among neonates with hyperEPO only, ISSI only, and hyperEPO+ISSI, to those who had neither hyperEPO nor ISSI, adjusting for gestational age. Results Newborns with hyperEPO, regardless of ISSI, were more than twice as likely as those without to have very low (< 55) Mental (OR 2.3; 95% CI 1.5-3.5) and/or Psychomotor (OR 2.4; 95% CI 1.6-3.7) Development Indices (MDI, PDI), and microcephaly at age two years (OR 2.4; 95%CI 1.5-3.8). Newborns with both hyperEPO and ISSI had significantly increased risks of ventriculomegaly, hemiparetic cerebral palsy, microcephaly, and MDI and PDI < 55 (ORs ranged from 2.2-6.3), but not hypoechoic lesions or other forms of cerebral palsy, relative to newborns with neither hyperEPO nor ISSI. Conclusion hyperEPO, regardless of ISSI, is associated with elevated risks of very low MDI and PDI, and microcephaly, but not with any form of cerebral palsy. Children with both hyperEPO and ISSI are at higher risk than others of very low MDI and PDI, ventriculomegaly, hemiparetic cerebral palsy, and microcephaly

Atomic and electronic reconstruction at van der Waals interface in twisted bilayer graphene

Control of the interlayer twist angle in two-dimensional (2D) van der Waals (vdW) heterostructures enables one to engineer a quasiperiodic moir\'e superlattice of tunable length scale. In twisted bilayer graphene (TBG), the simple moir\'e superlattice band description suggests that the electronic band width can be tuned to be comparable to the vdW interlayer interaction at a 'magic angle', exhibiting strongly correlated behavior. However, the vdW interlayer interaction can also cause significant structural reconstruction at the interface by favoring interlayer commensurability, which competes with the intralayer lattice distortion. Here we report the atomic scale reconstruction in TBG and its effect on the electronic structure. We find a gradual transition from incommensurate moir\'e structure to an array of commensurate domain structures as we decrease the twist angle across the characteristic crossover angle, $\theta_c$ ~1\deg. In the twist regime smaller than $\theta_c$ where the atomic and electronic reconstruction become significant, a simple moir\'e band description breaks down. Upon applying a transverse electric field, we observe electronic transport along the network of one-dimensional (1D) topological channels that surround the alternating triangular gapped domains, providing a new pathway to engineer the system with continuous tunability

Cranial Ultrasound Lesions in the NICU Predict Cerebral Palsy at Age 2 Years in Children Born at Extremely Low Gestational Age

Our prospective cohort study of extremely low gestational age newborns evaluated the association of neonatal head ultrasound abnormalities with cerebral palsy at age 2 years. Cranial ultrasounds in 1053 infants were read with respect to intraventricular hemorrhage, ventriculomegaly, and echolucency, by multiple sonologists. Standardized neurological examinations classified cerebral palsy, and functional impairment was assessed. Forty-four percent with ventriculomegaly and 52% with echolucency developed cerebral palsy. Compared with no ultrasound abnormalities, children with echolucency were 24 times more likely to have quadriparesis and 29 times more likely to have hemiparesis. Children with ventriculomegaly were 17 times more likely to have quadriparesis or hemiparesis. Forty-three percent of children with cerebral palsy had normal head ultrasound. Focal white matter damage (echolucency) and diffuse damage (late ventriculomegaly) are associated with a high probability of cerebral palsy, especially quadriparesis. Nearly half the cerebral palsy identified at 2 years is not preceded by a neonatal brain ultrasound abnormality. Originally published Journal of Child Neurology, Vol. 24, No. 1, Jan 200

Insights into the shock initiation/detonation of homogeneous and heterogeneous HE

It has long been known that there are fundamental differences between homogeneous and heterogeneous high explosives. The shock initiation behavior of these materials was first described in the literature by Campbell et al, in 1961. Chaiken was also involved in describing this process for liquid nitromethane. Since then, there have been a number of studies which have added considerable incite into the shock initiation/detonation behavior of these materials. We only give a few references here (Refs. 4 - 11) and these should be considered representative; e.g. they do not represent an exhaustive list of references available. Many of these studies were done on homogeneous explosives, most often nitromethane (NM) and include particle velocity gauge measurements, optical temperature measurements, VISAR measurements, as well as streak camera measurements of interfaces. In some cases NM was heterogenized by gelling and adding silica particles. Homogeneous materials are typically liquids or single crystals in which there are a minimal number of physical imperfections (e.g. bubbles or voids) that can cause perturbations in the input shock and the flow behind it. Homogeneous materials viewed with macroscopic probes characteristic of detonation physics experiments appear uniform. Heterogeneous explosives are generally all other types; these are usually pressed, cast, machined, or extruded into the shapes or parts desired. These materials contain imperfections of a variety of types that cause fluid-mechanical irregularities (called hot spots) when a shock or detonation wave passes over them. Such hot spots cause associated space/time fluctuations in the thermodynamic fields (e.g., the pressure or temperature fields) in the material. These thermodynamic variations affect the local chemical-heat-release rate - they produce an average heat-release rate that is a combination of chemistry and mechanics. Hot spots could be the result of voids, shock interactions, jetting, shock impedance mismatches, etc. Shock initiation of homogeneous explosives is due to a thermal explosion that occurs in the material shocked the longest. This reaction produces a reactive wave that grows behind the front and eventually overtakes the front. The reactive wave may grow into what is called a superdetonation before it overtakes the initial shock and settles down to a steady detonation. The shock initiation process in heterogeneous explosives differs a great deal because the hot spots cause early chemical reaction as soon as the shock passing over a region creates them. This causes reactive growth both in and behind the shock front. This leads to a relatively smooth growth of the initiating shock to a detonation, in contrast to the abrupt changes that occur in the homogeneous case. These differences are apparent in both the in-situ reaction wave profiles and the acceleration of the shock front

2008 Inter-laboratory Comparison Study of a Reference Material for Nutrients in Seawater

Autoclaved natural seawater collected in the North Pacific Ocean was used as a reference material for nutrients in seawater (RMNS) during an inter-laboratory comparison (I/C) study conducted in 2008. This study was a follow-up to previous studies conducted in 2003 and 2006. A set of six samples was distributed to each of 58 laboratories in 15 countries around the globe, and results were returned by 54 of those laboratories (15 countries). The homogeneities of samples used in the 2008 I/C study, based on analyses for three determinants, were improved compared to those of samples used in the 2003 and 2006 I/C studies. Results of these I/C studies indicate that most of the participating laboratories have an analytical technique for nutrients that is sufficient to provide data of high comparability. The differences between reported concentrations from the same laboratories in the 2006 and 2008 I/C studies for the same batch of RMNS indicate that most of the laboratories have been maintaining internal comparability for two years. Thus, with the current high level of performance in the participating laboratories, the use of a common reference material and the adaptation of an internationally accepted nutrient scale system would increase comparability among laboratories worldwide, and the use of a certified reference material would establish traceability. In the 2008 I/C study we observed a problem of non-linearity of the instruments of the participating laboratories similar to that observed among the laboratories in the 2006 I/C study. This problem of non-linearity should be investigated and discussed to improve comparability for the full range of nutrient concentrations. For silicate comparability in particular, we see relatively larger consensus standard deviations than those for nitrate and phosphate