Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study.

BACKGROUND: Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. OBJECTIVE: to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old. METHODS: This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment. RESULTS: 342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions. DISCUSSION: In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children

Scheduling Jobs in Flowshops with the Introduction of Additional Machines in the Future

This is the author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier and can be found at: http://www.journals.elsevier.com/expert-systems-with-applications/.The problem of scheduling jobs to minimize total weighted tardiness in flowshops,\ud with the possibility of evolving into hybrid flowshops in the future, is investigated in\ud this paper. As this research is guided by a real problem in industry, the flowshop\ud considered has considerable flexibility, which stimulated the development of an\ud innovative methodology for this research. Each stage of the flowshop currently has\ud one or several identical machines. However, the manufacturing company is planning\ud to introduce additional machines with different capabilities in different stages in the\ud near future. Thus, the algorithm proposed and developed for the problem is not only\ud capable of solving the current flow line configuration but also the potential new\ud configurations that may result in the future. A meta-heuristic search algorithm based\ud on Tabu search is developed to solve this NP-hard, industry-guided problem. Six\ud different initial solution finding mechanisms are proposed. A carefully planned\ud nested split-plot design is performed to test the significance of different factors and\ud their impact on the performance of the different algorithms. To the best of our\ud knowledge, this research is the first of its kind that attempts to solve an industry-guided\ud problem with the concern for future developments

Factors associated with postmenstrual age at full oral feeding in very preterm infants.

We aimed to identify variables associated with gestational age at full oral feeding in a cohort of very preterm infants. In this retrospective study, all infants born below 32 weeks of gestation and admitted to a level III neonatal unit in 2015 were included. We dichotomized our population of 122 infants through the median age at full oral feeding, and explored which variables were statistically different between the two groups. We then used linear regression analysis to study the association between variables known from the literature and variables we had identified and age at full oral feeding. The median postnatal age at full oral feeding was 36 6/7weeks post menstrual age (Q1-Q3 35 6/7-392/7), and was associated with the duration of hospital of stay. In the univariable linear regression, the variables significantly associated with full oral feeding were gestational age, socioeconomic status, sepsis, patent ductus arteriosus, duration of supplementary oxygen, of non-invasive and invasive ventilation, and bronchopulmonary dysplasia. In the multivariable regression analysis, duration of non-invasive ventilation and oxygen therapy, bronchopulmonary dysplasia, and patent ductus arteriosus were associated with an older age at full oral feeding, with bronchopulmonary dysplasia the single most potent predictor. Lung disease severity is a major determinant of age at full oral feeding and thus length of stay in this population. Other factors associated with FOF include socioeconomic status and patent ductus arteriosus, There is a need for research addressing evidence-based bundles of care for these infants at risk of long-lasting feeding and neurodevelopmental impairments

Asymptotic description of solutions of the exterior Navier Stokes problem in a half space

We consider the problem of a body moving within an incompressible fluid at constant speed parallel to a wall, in an otherwise unbounded domain. This situation is modeled by the incompressible Navier-Stokes equations in an exterior domain in a half space, with appropriate boundary conditions on the wall, the body, and at infinity. We focus on the case where the size of the body is small. We prove in a very general setup that the solution of this problem is unique and we compute a sharp decay rate of the solution far from the moving body and the wall

Kasabach-Merritt phenomenon and prenatal counseling: a case series.

Kasabach-Merritt phenomenon can be encountered in the perinatal period. No consensus exists regarding prenatal management. We report one prenatal case leading to therapeutic abortion and one neonatal case, successfully treated by a multimodal therapy. Prenatal counseling should include the possibility of neonatal multimodal treatment that can lead to favorable outcomes

Potentially modifiable predictors of adverse neonatal and maternal outcomes in pregnancies with gestational diabetes mellitus: can they help for future risk stratification and risk-adapted patient care?

Gestational diabetes mellitus (GDM) exposes mothers and their offspring to short and long-term complications. The objective of this study was to identify the importance of potentially modifiable predictors of adverse outcomes in pregnancies with GDM. We also aimed to assess the relationship between maternal predictors and pregnancy outcomes depending on HbA1c values and to provide a risk stratification for adverse pregnancy outcomes according to the prepregnancy BMI (Body mass index) and HbA1c at the 1st booking. This prospective study included 576 patients with GDM. Predictors were prepregnancy BMI, gestational weight gain (GWG), excessive weight gain, fasting, 1 and 2-h glucose values after the 75 g oral glucose challenge test (oGTT), HbA1c at the 1st GDM booking and at the end of pregnancy and maternal treatment requirement. Maternal and neonatal outcomes such as cesarean section, macrosomia, large and small for gestational age (LGA, SGA), neonatal hypoglycemia, prematurity, hospitalization in the neonatal unit and Apgar score at 5 min < 7 were evaluated. Univariate and multivariate regression analyses and probability analyses were performed. One-hour glucose after oGTT and prepregnancy BMI were correlated with cesarean section. GWG and HbA1c at the end pregnancy were associated with macrosomia and LGA, while prepregnancy BMI was inversely associated with SGA. The requirement for maternal treatment was correlated with neonatal hypoglycemia, and HbA1c at the end of pregnancy with prematurity (all p < 0.05). The correlations between predictors and pregnancy complications were exclusively observed when HbA1c was ≥5.5% (37 mmol/mol). In women with prepregnancy BMI ≥ 25 kg/m <sup>2</sup> and HbA1c ≥ 5.5% (37 mmol/mol) at the 1st booking, the risk for cesarean section and LGA was nearly doubled compared to women with BMI with < 25 kg/m <sup>2</sup> and HbA1c < 5.5% (37 mmol/mol). Prepregnancy BMI, GWG, maternal treatment requirement and HbA1c at the end of pregnancy can predict adverse pregnancy outcomes in women with GDM, particularly when HbA1c is ≥5.5% (37 mmol/mol). Stratification based on prepregnancy BMI and HbA1c at the 1st booking may allow for future risk-adapted care in these patients

Exceptionally Slow Rise in Differential Reflectivity Spectra of Excitons in GaN: Effect of Excitation-induced Dephasing

Femtosecond pump-probe (PP) differential reflectivity spectroscopy (DRS) and four-wave mixing (FWM) experiments were performed simultaneously to study the initial temporal dynamics of the exciton line-shapes in GaN epilayers. Beats between the A-B excitons were found \textit{only for positive time delay} in both PP and FWM experiments. The rise time at negative time delay for the differential reflection spectra was much slower than the FWM signal or PP differential transmission spectroscopy (DTS) at the exciton resonance. A numerical solution of a six band semiconductor Bloch equation model including nonlinearities at the Hartree-Fock level shows that this slow rise in the DRS results from excitation induced dephasing (EID), that is, the strong density dependence of the dephasing time which changes with the laser excitation energy.Comment: 8 figure

Trapping and cooling single atoms with far-off resonance intracavity doughnut modes

We investigate cooling and trapping of single atoms inside an optical cavity using a quasi-resonant field and a far-off resonant mode of the Laguerre-Gauss type. The far-off resonant doughnut mode provides an efficient trapping in the case when it shifts the atomic internal ground and excited state in the same way, which is particularly useful for quantum information applications of cavity quantum electrodynamics (QED) systems. Long trapping times can be achieved, as shown by full 3-D simulations of the quasi-classical motion inside the resonator.Comment: 18 pages, 18 figures, RevTe